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1. PARP inhibitors in prostate cancers, is it time for combinations?

Author

Diego Teyssonneau, Charles Dariane, Eric Barret, Jean-Baptiste Beauval, Laurent Brureau, Gaëlle Fiard, Gaëlle Fromont, Gilles Créhange, Mathieu Gauthé, Alain Ruffion, Raphaële Renard-Penna, Romain Mathieu, Paul Sargos, Morgan Rouprêt, Guillaume Ploussard, and Guilhem Roubaud

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Despite several improvements in outcomes, metastatic prostate cancer remains deadly. Alterations in the homologous recombination repair (HRR) pathway are associated with more aggressive disease. Olaparib and rucaparib, two poly-ADP-ribose polymerase (PARP) inhibitors, have received approval from the authorities of several countries for their anti-tumoral effects in patients with metastatic castration-resistant prostate cancers harboring HRR gene alterations, in particular BRCA2 . More recently, it has been hypothesized that new hormonal therapies (NHTs) and PARP inhibitors (PARPi) could have synergistic actions and act independently of HRR deficiency. This review proposes to discuss the advantages and disadvantages of PARPi used as monotherapy or in combination with NHTs and whether there is a need for molecular selection.

Published
2024
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2. Automatic segmentation of prostate zonal anatomy on MRI: a systematic review of the literature

Author

Carine Wu, Sarah Montagne, Dimitri Hamzaoui, Nicholas Ayache, Hervé Delingette, and Raphaële Renard-Penna

Subjects
Artificial intelligence, Deep learning, Magnetic resonance imaging, Prostate cancer, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Key points Several limitations exist with current methods of automatic prostate segmentation. There is wide variability of databases, imaging tasks and assessment criteria. No preferred methodology for prostate zonal segmentation methodology and terminology was used. Vast majority of papers share common methodological flaws discussed in this review.

Published
2022
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3. Clinical Trial Protocol for PERFECT: A Randomised Controlled Trial Comparing the Efficiency and Tolerance of Transperineal Fusion Versus Transrectal Imaging-targeted Prostate Biopsies (CCAFU-PR1 Study)

Author

Alae Touzani, Gaëlle Fiard, Eric Barret, Raphaële Renard-Penna, Ambroise Salin, Benjamin Pradère, François Rozet, Jean-Baptiste Beauval, Bernard Malavaud, Gianluca Giannarini, Pierre Colin, Morgan Rouprêt, and Guillaume Ploussard

Subjects
Prostate cancer, Fusion biopsy, Transperineal, Transrectal, Efficiency, Complications, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

PERFECT is a multicentre randomised controlled clinical trial that evaluates the efficiency of fusion magnetic resonance imaging–targeted biopsies in the transperineal (TP) versus transrectal (TR) approach in terms of the detection of significant cancers. Our study builds on the hypothesis that the TP approach for prostate biopsies has at least the same diagnostic accuracy as the TR approach, with lower morbidity. Here, we describe the clinical protocol, study population, and primary and secondary outcomes.

Published
2022
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4. Promoting the use of the PRECISE score for prostate MRI during active surveillance: results from the ESOR Nicholas Gourtsoyiannis teaching fellowship

Author

Francesco Giganti, Laurene Aupin, Camille Thoumin, Ingrid Faouzi, Hippolyte Monnier, Matthieu Fontaine, Alexandre Navidi, Paul-Gydéon Ritvo, Valentin Ong, Cecile Chung, Imen Bibi, Raphaële Lehrer, Nicolas Hermieu, Eric Barret, Alessandro Ambrosi, Veeru Kasivisvanathan, Mark Emberton, Clare Allen, Alex Kirkham, Caroline M. Moore, and Raphaële Renard-Penna

Subjects
Urogenital neoplasms, Prostatic neoplasms, Magnetic resonance imaging, Biopsy, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Abstract Objectives The PRECISE criteria for serial multiparametric magnetic resonance imaging (MRI) of the prostate during active surveillance recommend the use of a dedicated scoring system (PRECISE score) to assess the likelihood of clinically significant radiological change. This pilot study assesses the effect of an interactive teaching course on prostate MRI during active surveillance in assessing radiological change in serial imaging. Methods Eleven radiology fellows and registrars with different experience in prostate MRI reading participated in a dedicated teaching course where they initially evaluated radiological change (based on their previous training in prostate MRI reading) independently in fifteen patients on active surveillance (baseline and follow-up scan), and then attended a lecture on the PRECISE score. The initial scans were reviewed for teaching purposes and afterwards the participants re-assessed the degree of radiological change in a new set of images (from fifteen different patients) applying the PRECISE score. Receiver operating characteristic analysis was performed. Confirmatory biopsies and PRECISE scores given in consensus by two radiologists (involved in the original draft of the PRECISE score) were the reference standard. Results There was a significant improvement in the average area under the curve (AUC) for the assessment of radiological change from baseline (AUC: 0.60 [Confidence Intervals: 0.51–0.69] to post-teaching (AUC: 0.77 [0.70–0.84]). This was an improvement of 0.17 [0.016–0.28] (p = 0.004). Conclusions A dedicated teaching course on the use of the PRECISE score improves the accuracy in the assessment of radiological change in serial MRI of the prostate.

Published
2022
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5. Vasectomy and Risk of Prostate Cancer: A Systematic Review and Meta-analysis

Author

Michael Baboudjian, Pawel Rajwa, Eric Barret, Jean-Baptiste Beauval, Laurent Brureau, Gilles Créhange, Charles Dariane, Gaëlle Fiard, Gaëlle Fromont, Mathieu Gauthé, Romain Mathieu, Raphaële Renard-Penna, Guilhem Roubaud, Alain Ruffion, Paul Sargos, Morgan Rouprêt, and Guillaume Ploussard

Subjects
Vasectomy, Prostate cancer, Meta-analysis, Localized, Advanced, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Context: Previous reports have shown an association between vasectomy and prostate cancer (PCa). However, there exist significant discrepancies between studies and systematic reviews due to a lack of strong causal association and residual confounding factors such as prostate-specific antigen (PSA) screening. Objective: To assess the association between vasectomy and PCa, in both unadjusted and PSA screen-adjusted studies. Evidence acquisition: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The PubMed, Scopus, and Web of Science databases were searched in January 2022 for studies that analyzed the association between vasectomy and PCa. Evidence synthesis: A total of 37 studies including 16 931 805 patients met our inclusion criteria. A pooled analysis from all studies showed a significant association between vasectomy and any-grade PCa (odds ratio [OR] 1.23; 95% confidence interval [CI], 1.10–1.37; p

Published
2022
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6. Comparing biparametric to multiparametric MRI in the diagnosis of clinically significant prostate cancer in biopsy-naive men (PRIME): a prospective, international, multicentre, non-inferiority within-patient, diagnostic yield trial protocol

Author

Jonathan J Deeks, Chris Brew-Graves, Yemisi Takwoingi, Aiman Haider, Clare Allen, Alex Freeman, Mark Emberton, Antti Rannikko, John Wilkinson, Daniel Margolis, Enrique Gomez Gomez, Sangeet Ghai, Alex Kirkham, Veeru Kasivisvanathan, Caroline M Moore, Hazel McBain, Anders Bjartell, Paula Lorgelly, Pramit Khetrapal, Shonit Punwani, Nicola Muirhead, Ridhi Agarwal, Philip Ryan, Caroline S Clarke, Aqua Asif, Peter Albertsen, Alexander Ng, Francesco Giganti, Louise Dickinson, Jeremy Grummet, Vinson Wai-Shun Chan, Arjun Nathan, Marimo Rossiter, Réka Novotta, Tushar Narain, Antonette Andrews, Valeria Panebianco, Lance Mynderse, Adam Froemming, Naoki Takahasi, Tristan Barrett, Raphaële Renard-Penna, Vibeke Løgager, Lars Boesen, Lars Budäus, Tho Pham, Jing Yi Jessica Weng, Wim Witjes, Christien Caris, and Joke Van Egmond

Subjects
Medicine
Abstract

Introduction Prostate MRI is a well-established tool for the diagnostic work-up for men with suspected prostate cancer (PCa). Current recommendations advocate the use of multiparametric MRI (mpMRI), which is composed of three sequences: T2-weighted sequence (T2W), diffusion-weighted sequence (DWI) and dynamic contrast-enhanced sequence (DCE). Prior studies suggest that a biparametric MRI (bpMRI) approach, omitting the DCE sequences, may not compromise clinically significant cancer detection, though there are limitations to these studies, and it is not known how this may affect treatment eligibility. A bpMRI approach will reduce scanning time, may be more cost-effective and, at a population level, will allow more men to gain access to an MRI than an mpMRI approach.Methods Prostate Imaging Using MRI±Contrast Enhancement (PRIME) is a prospective, international, multicentre, within-patient diagnostic yield trial assessing whether bpMRI is non-inferior to mpMRI in the diagnosis of clinically significant PCa. Patients will undergo the full mpMRI scan. Radiologists will be blinded to the DCE and will initially report the MRI using only the bpMRI (T2W and DWI) sequences. They will then be unblinded to the DCE sequence and will then re-report the MRI using the mpMRI sequences (T2W, DWI and DCE). Men with suspicious lesions on either bpMRI or mpMRI will undergo prostate biopsy. The main inclusion criteria are men with suspected PCa, with a serum PSA of ≤20 ng/mL and without prior prostate biopsy. The primary outcome is the proportion of men with clinically significant PCa detected (Gleason score ≥3+4 or Gleason grade group ≥2). A sample size of at least 500 patients is required. Key secondary outcomes include the proportion of clinically insignificant PCa detected and treatment decision.Ethics and dissemination Ethical approval was obtained from the National Research Ethics Committee West Midlands, Nottingham (21/WM/0091). Results of this trial will be disseminated through peer-reviewed publications. Participants and relevant patient support groups will be informed about the results of the trial.Trial registration number NCT04571840.

Published
2023
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7. A 5-Year Contemporary Nationwide Evolution of the Radical Prostatectomy Landscape

Author

Guillaume Ploussard, Annabelle Grabia, Jean-Baptiste Beauval, Eric Barret, Laurent Brureau, Charles Dariane, Gaëlle Fiard, Gaëlle Fromont, Mathieu Gauthé, Romain Mathieu, Raphaële Renard-Penna, Guilhem Roubaud, Alain Ruffion, Paul Sargos, François Rozet, Charles-Edouard Lequeu, and Morgan Rouprêt

Subjects
Prostate cancer, Radical prostatectomy, Readmission, Complication, Volume, Cost, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

The evolution in the past decade of recommendations for prostate cancer (PCa) management, from screening to surgical treatment, may have affected the radical prostatectomy (RP) landscape. However, comprehensive data at a national level remain scarce. We extracted 5-yr data for RP patients in France from the central database of the national health care system. The primary endpoints were surgical approach (open [ORP], laparoscopic [LRP], and robot-assisted RP [RARP]), length of stay (LOS), and complication and readmission rates. The annual number of RPs was stable during the study period. The proportion of RARPs increased from 39.8% in 2015 to 52.6% in 2019, whereas the proportion of ORPs decreased from 34.4% to 24.5%. LOS continuously decreased over time irrespective of the surgical approach. The proportion of centres in the highest quartile of hospital volume increased from 22.0% to 28.3% (p = 0.006). LOS and complication and readmission rates were significantly lower (p

Published
2021
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8. Challenge of prostate MRI segmentation on T2-weighted images: inter-observer variability and impact of prostate morphology

Author

Sarah Montagne, Dimitri Hamzaoui, Alexandre Allera, Malek Ezziane, Anna Luzurier, Raphaelle Quint, Mehdi Kalai, Nicholas Ayache, Hervé Delingette, and Raphaële Renard-Penna

Subjects
Prostate, MRI, Segmentation, Zones, Atlas, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Abstract Background Accurate prostate zonal segmentation on magnetic resonance images (MRI) is a critical prerequisite for automated prostate cancer detection. We aimed to assess the variability of manual prostate zonal segmentation by radiologists on T2-weighted (T2W) images, and to study factors that may influence it. Methods Seven radiologists of varying levels of experience segmented the whole prostate gland (WG) and the transition zone (TZ) on 40 axial T2W prostate MRI images (3D T2W images for all patients, and both 3D and 2D images for a subgroup of 12 patients). Segmentation variabilities were evaluated based on: anatomical and morphological variation of the prostate (volume, retro-urethral lobe, intensity contrast between zones, presence of a PI-RADS ≥ 3 lesion), variation in image acquisition (3D vs 2D T2W images), and reader’s experience. Several metrics including Dice Score (DSC) and Hausdorff Distance were used to evaluate differences, with both a pairwise and a consensus (STAPLE reference) comparison. Results DSC was 0.92 (± 0.02) and 0.94 (± 0.03) for WG, 0.88 (± 0.05) and 0.91 (± 0.05) for TZ respectively with pairwise comparison and consensus reference. Variability was significantly (p

Published
2021
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9. Same-day-discharge Robot-assisted Radical Prostatectomy: An Annual Countrywide Analysis

Author

Guillaume Ploussard, Annabelle Grabia, Eric Barret, Jean-Baptiste Beauval, Laurent Brureau, Gilles Créhange, Charles Dariane, Gaëlle Fiard, Gaëlle Fromont, Mathieu Gauthé, Romain Mathieu, Raphaële Renard-Penna, Guilhem Roubaud, Alain Ruffion, Paul Sargos, Morgan Rouprêt, and Charles-Edouard Lequeu

Subjects
Prostate cancer, Radical prostatectomy, Readmission, Outpatient, Volume, Cost, Diseases of the genitourinary system. Urology, RC870-923, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

There are no countrywide data regarding the utilization of same-day-discharge (SDD) surgery for robot-assisted radical prostatectomy (RARP). We aimed to evaluate the annual number of SDD RARP procedures in France and to compare postoperative outcomes in SDD versus non-SDD centers. Data for all 9651 patients undergoing RARP in France in 2020 were extracted from the central database of the national healthcare system. Endpoints were length of hospital stay, patient age, center volume, lymph node dissection, and the hospital readmission rate. Overall, 184 SDD cases (1.9%) were reported in 14.2% of RARP centers. The annual RARP and SDD RARP caseload ranged from 41 to 485, and from one to 47, respectively, in SDD centers. SDD was significantly associated with higher-volume centers (p < 0.001). No difference in readmission rate (7.9% vs 5.1%; p = 0.141) was observed for SDD versus non-SDD centers. Direct stay costs were estimated at €1457 in SDD centers compared to €2021 in non-SDD centers. The main limitation is the lack of detailed patient characteristics and readmission causes. This annual nationwide analysis suggests that SDD RARP remains infrequently used in routine practice in France despite being associated with comparable short-term outcomes after RARP and potential cost benefits. Patient summary: We evaluated the use of robot-assisted removal of the prostate (RARP) with same-day hospital discharge in France for men with prostate cancer. In 2020, only 1.9% of the 9651 RARP procedures involved same-day discharge, even though the data show that this approach has lower costs and comparable safety.

Published
2022
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10. Targeting Local Recurrence After Surgery With MRI Imaging for Prostate Cancer in the Setting of Salvage Radiation Therapy

Author

Raphaële Renard-Penna, Jules Zhang-Yin, Sarah Montagne, Laurene Aupin, Eric Bruguière, Mouna Labidi, Igor Latorzeff, and Christophe Hennequin

Subjects
prostate cancer, prostatectomy, MRI, diffusion magnetic resonance imaging, local neoplasm recurrence, radiation therapy, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Magnetic resonance imaging (MRI) is being increasingly used for imaging suspected recurrence in prostate cancer therapy. Functional MRI with diffusion and perfusion imaging has the potential to demonstrate local recurrence even at low PSA value. Detection of recurrence can modify the management of postprostatectomy biochemical recurrence. MRI scan acquired before salvage radiotherapy is useful for the localization of recurrent tumors and also in the delineation of the target volume. The objective of this review is to assess the role and potential impact of MRI in targeting local recurrence after surgery for prostate cancer in the setting of salvage radiation therapy.

Published
2022
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11. Cancer du pénis : problèmes pratiques du quotidien, de la biopsie à la chirurgie

Author

Benjamin Pradere, Raphaële Renard-Penna, Philippe Moguelet, and Eva Compérat

Subjects
0301 basic medicine, Gynecology, 03 medical and health sciences, medicine.medical_specialty, 030104 developmental biology, 0302 clinical medicine, 030220 oncology & carcinogenesis, Philosophy, medicine, 3. Good health, Pathology and Forensic Medicine
Abstract

Resume La prise en charge dun cancer de penis est complexe, une collaboration entre radiologue, pathologiste et urologue est necessaire pour etablir un staging correct. Dans cette revue nous essayons de montrer comment on peut obtenir un compte–rendu complet (imagerie, biopsie, examen extemporane) et comment prendre en charge le malade (traitement chirurgicaux et autres).

Published
2022

12. Automatic Zonal Segmentation of the Prostate from 2D and 3D T2-weighted MRI and Evaluation for Clinical Use

Author

Dimitri, Hamzaoui, Sarah, Montagne, Raphaële, Renard-Penna, Nicholas, Ayache, Hervé, Delingette, E-Patient : Images, données & mOdèles pour la médeciNe numériquE (EPIONE), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de Recherche Clinique Onco-Urologie Prédictive (GRC 5), Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], PAIMRI, ANR-17-EURE-0004,UCA DS4H,UCA Systèmes Numériques pour l'Homme(2017), and ANR-19-P3IA-0002,3IA@cote d'azur,3IA Côte d'Azur(2019)

Subjects
Segmentation, Deep Learning, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Image Processing, Prostate, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Radiology, Nuclear Medicine and imaging, Lesion, Magnetic Resonance Imaging, Inter-rater Variability, [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI]
Abstract

PURPOSE: An accurate zonal segmentation of the prostate is required for prostate cancer (PCa) management with MRI. APPROACH: The aim of this work is to present UFNet, a deep learning-based method for automatic zonal segmentation of the prostate from T2-weighted (T2w) MRI. It takes into account the image anisotropy, includes both spatial and channelwise attention mechanisms and uses loss functions to enforce prostate partition. The method was applied on a private multicentric three-dimensional T2w MRI dataset and on the public two-dimensional T2w MRI dataset ProstateX. To assess the model performance, the structures segmented by the algorithm on the private dataset were compared with those obtained by seven radiologists of various experience levels. RESULTS: On the private dataset, we obtained a Dice score (DSC) of [Formula: see text] for the whole gland (WG), [Formula: see text] for the transition zone (TZ), and [Formula: see text] for the peripheral zone (PZ). Results were significantly better than other compared networks’ ([Formula: see text]). On ProstateX, we obtained a DSC of [Formula: see text] for WG, [Formula: see text] for TZ, and [Formula: see text] for PZ. These results are similar to state-of-the art results and, on the private dataset, are coherent with those obtained by radiologists. Zonal locations and sectorial positions of lesions annotated by radiologists were also preserved. CONCLUSIONS: Deep learning-based methods can provide an accurate zonal segmentation of the prostate leading to a consistent zonal location and sectorial position of lesions, and therefore can be used as a helping tool for PCa diagnosis.

Published
2022

13. A comparative study of peptide-based imaging agents [68Ga]Ga-PSMA-11, [68Ga]Ga-AMBA, [68Ga]Ga-NODAGA-RGD and [68Ga]Ga-DOTA-NT-20.3 in preclinical prostate tumour models

Author

Jules Zhang-Yin, Mallaurie Penent, Françoise Montravers, Olivier Cussenot, Geraldine Cancel-Tassin, Eva Compérat, Jean-Noël Talbot, Timofei Rusu, Raphaële Renard-Penna, Camelia Radulescu, Aurélie Prignon, Claire Provost, Service de médecine nucléaire [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Phénotypage du petit animal (UMS28), Sorbonne Université (SU), Laboratoire d'Imagerie Moléculaire Positonique - IFR 65 (LIMP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Hôpital Foch [Suresnes]

Subjects
Biochemical recurrence, Cancer Research, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, urologic and male genital diseases, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, chemistry.chemical_compound, Prostate cancer, 0302 clinical medicine, Prostate, PSMA, medicine, Gastrin-releasing peptide receptor, DOTA, Radiology, Nuclear Medicine and imaging, Fluorodeoxyglucose, NTSR1, medicine.diagnostic_test, Chemistry, GRPr, Bone metastasis, medicine.disease, 3. Good health, PET, medicine.anatomical_structure, Positron emission tomography, 030220 oncology & carcinogenesis, Cancer research, Molecular Medicine, medicine.drug
Abstract

Introduction Peptide-based imaging agents targeting prostate-specific membrane antigen (PSMA) have revolutionized the evaluation of biochemical recurrence of prostate cancer (PCa) but lacks sensitivity at very low serum prostate specific antigen (PSA) levels. Once recurrence is suspected, other positron emission tomography (PET) radiotracers could be of interest to discriminate between local and distant relapse. We studied [18F]fluorodeoxyglucose ([18F]FDG) targeting glucose metabolism, [18F]fluorocholine ([18F]FCH) targeting membrane metabolism and peptide-based imaging agents [68Ga]Ga-PSMA-11, [68Ga]Ga-AMBA, [68Ga]Ga-NODAGA-RGD and [68Ga]Ga-DOTA-NT-20.3 targeting PSMA, gastrin releasing peptide receptor (GRPr), αvβ3 integrin and neurotensin type 1 receptor (NTSR1) respectively, in different PCa tumour models. Methods Mice were xenografted with 22Rv1, an androgen-receptor (AR)-positive, PCa cell line that expresses PSMA and PC3, an AR-negative one that does not express PSMA. PET imaging using the different radiotracers was performed sequentially and the uptake characteristics compared to one other. NTSR1 and PSMA expression levels were analysed in tumours by immunohistochemistry. Results [18F]FDG displayed low but sufficient uptake to visualize PC3 and 22Rv1 derived tumours. We also observed a low efficacy of [18F]FCH PET imaging and a low [68Ga]Ga-NODAGA-RGD tumour uptake in those tumours. As expected, an elevated tumour uptake was obtained for [68Ga]Ga-PSMA-11 in 22Rv1 derived tumour although no uptake was measured in the androgen independent cell line PC3, derived from a bone metastasis of a high-grade PCa. Moreover, in PC3 cell line, we obtained good tumour uptake, high tumour-to-background contrast using [68Ga]Ga-AMBA and [68Ga]Ga-DOTA-NT-20.3. Immunohistochemistry analysis confirmed high NTSR1 expression in PC3 derived tumours and conversely high PSMA expression in 22Rv1 derived tumours. Conclusion PET imaging using [68Ga]Ga-AMBA and [68Ga]Ga-DOTA-NT-20.3 demonstrates that GRPr and NTSR1 could represent viable alternative targets for diagnostic or therapeutic applications in PCa with limited PSMA expression levels. More preclinical and clinical studies will follow to explore this potential. Advances in knowledge and implications for patient Peptide-based imaging agents targeting PSMA represent a major progress in the evaluation of biochemical recurrence of PCa but sometimes yield false negative results in some lesions. Continuing efforts have thus been made to evaluate other radiotracers. Our preclinical results suggest that [68Ga]labelled bombesin and neurotensin analogues could serve as alternative PET radiopharmaceuticals for diagnostic or therapy in cases of PSMA-negative PCa.

Published
2020

14. PARP Inhibitors as Monotherapy in Daily Practice for Advanced Prostate Cancers

Author

Diego, Teyssonneau, Antoine, Thiery-Vuillemin, Charles, Dariane, Eric, Barret, Jean-Baptiste, Beauval, Laurent, Brureau, Gilles, Créhange, Gaëlle, Fiard, Gaëlle, Fromont, Mathieu, Gauthé, Alain, Ruffion, Raphaële, Renard-Penna, Romain, Mathieu, Paul, Sargos, Morgan, Rouprêt, Guillaume, Ploussard, Guilhem, Roubaud, On Behalf Of The Cc-Afu Cancerology Committee Of The Association Française d'Urologie, Institut Bergonié [Bordeaux], UNICANCER, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Institut Mutualiste de Montsouris (IMM), Clinique La Croix du Sud, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Curie [Paris], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Groupe Hospitalier Mutualiste [Grenoble] (GHM), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre pour l'innovation en cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut de recherche en santé, environnement et travail (Irset), and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
prostate cancers, [SDV]Life Sciences [q-bio], DNA repair, General Medicine, PARP inhibitors, homologous recombination repair
Abstract

International audience; Despite recent improvements in survival, metastatic castration-resistant prostate cancers (mCRPCs) remain lethal. Alterations in genes involved in the homologous recombination repair (HRR) pathway are associated with poor prognosis. Poly-ADP-ribose polymerase (PARP) inhibitors (PARPis) have demonstrated anti-tumoral effects by synthetic lethality in patients with mCRPCs harboring HRR gene alterations, in particular BRCA2. While both olaparib and rucaparib have obtained government approvals for use, the selection of eligible patients as well as the prescription of these treatments within the clinical urology community are challenging. This review proposes a brief review of the rationale and outcomes of PARPi treatment, then a pragmatic vision of PARPi use in terms of prescription and the selection of patients based on molecular screening, which can involve potential genetic counseling in the case of associated germinal alterations.

Published
2022

15. Prostate volume prediction on MRI: tools, accuracy and variability

Author

Dimitri Hamzaoui, Sarah Montagne, Benjamin Granger, Alexandre Allera, Malek Ezziane, Anna Luzurier, Raphaëlle Quint, Mehdi Kalai, Nicholas Ayache, Hervé Delingette, Raphaële Renard-Penna, HAMZAOUI, Dimitri, UCA Systèmes Numériques pour l'Homme - - UCA DS4H2017 - ANR-17-EURE-0004 - EURE - VALID, 3IA Côte d'Azur - - 3IA@cote d'azur2019 - ANR-19-P3IA-0002 - P3IA - VALID, E-Patient : Images, données & mOdèles pour la médeciNe numériquE (EPIONE), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Université Côte d'Azur (UCA), Service de Radiologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Groupe de Recherche Clinique Onco-Urologie Prédictive [CHU Tenon] (GRC 5), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Département de santé publique [CHU Pitié-Salpêtrière], PAIMRI, ANR-17-EURE-0004,UCA DS4H,UCA Systèmes Numériques pour l'Homme(2017), ANR-19-P3IA-0002,3IA@cote d'azur,3IA Côte d'Azur(2019), Service de Radiologie [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Département de santé publique, Groupe de Recherche Clinique Onco-Urologie Prédictive (GRC 5), and Sorbonne Université (SU)

Subjects
Male, [STAT.AP]Statistics [stat]/Applications [stat.AP], Volume, Prostate, [INFO.INFO-IM] Computer Science [cs]/Medical Imaging, Prostatic Neoplasms, Reproducibility of Results, General Medicine, Magnetic Resonance Imaging, PSA density, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Segmentation, [STAT.AP] Statistics [stat]/Applications [stat.AP], [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Radiology, Nuclear Medicine and imaging
Abstract

The original publication is available at www.springerlink.com: https://link.springer.com/article/10.1007/s00330-022-08554-4; International audience; OBJECTIVE: A reliable estimation of prostate volume (PV) is essential to prostate cancer management. Theobjective of our multi-rater study was to compare intra and inter-rater variability of PV frommanual planimetry and ellipsoid formulas.METHODS: Forty treatment-naive patients who underwent prostate MRI were selected from a localdatabase. PV and corresponding PSA density (PSAd) were estimated on 3D T2-weighted MRI(3T) by 7 independent radiologists using the traditional ellipsoid formula (TEF),the newerbiproximate ellipsoid formula (BPEF), and the manual planimetry method (MPM) used asground truth. Intra and inter-rater variability was calculated using the mixed model basedintraclass correlation coefficient (ICC).RESULTS: Mean volumes were 67.00 (±36.61), 66.07(±35.03), and 64.77(±38.27)cm 3 with the TEF,BPEF, and MPM methods respectively. Both TEF and BPEF overestimated PV relative toMPM, with the former presenting significant differences (+1.91cm3, IQ=[-0.33cm3, 5.07cm3],p-val=0.03). Both intra (ICC>0.90) and inter-rater (ICC>0.90) reproducibility were excellent. MPM had thehighest inter-rater reproducibility (ICC=0.999). Inter-rater PV variation led to discrepancies inclassification according to the clinical criterion of PSAd>0.15ng/mL for 2 patients (5%), 7patients (17.5%), and 9 patients (22.5%) when using MPM, TEF, and BPEF respectively.CONCLUSION: PV measurements using ellipsoid formulas and MPM are highly reproducible. MPM is a robustmethod for PV assessment and PSAd calculation, with the lowest variability. TEF showed ahigh degree of concordance with MPM but a slight overestimation of PV. Precise anatomiclandmarks as defined with the BPEF led to a more accurate PV estimation, but also to a highervariability.

Published
2022

16. Overview of the Development and Use of Akt Inhibitors in Prostate Cancer

Author

Anis Gasmi, Guilhem Roubaud, Charles Dariane, Eric Barret, Jean-Baptiste Beauval, Laurent Brureau, Gilles Créhange, Gaëlle Fiard, Gaëlle Fromont, Mathieu Gauthé, Alain Ruffion, Raphaële Renard-Penna, Paul Sargos, Morgan Rouprêt, Guillaume Ploussard, Romain Mathieu, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut Bergonié [Bordeaux], UNICANCER, Service d'Urologie [CHU Georges Pompidou], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'urologie [Institut Mutualiste Montsouris], Institut Mutualiste de Montsouris (IMM), Clinique La Croix du Sud, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Curie [Paris], Service d'Anatomopathologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de médecine nucléaire [CHU Grenoble], Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre pour l'innovation en cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de Recherche Clinique Onco-Urologie Prédictive (GRC 5), Sorbonne Université (SU), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de Radiologie Polyvalente et Oncologique = Service d'Imagerie Spécialisées et des Urgences [CHU Pitié-Salpêtrière] (SISU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de Recherche Clinique Onco-Urologie Prédictive [CHU Tenon] (GRC 5), CHU Tenon [AP-HP], Service d'Urologie [CHU Pitié-Salpêtrière], and Gestionnaire, Hal Sorbonne Université

Subjects
PTEN, Akt, Ipatasertib, [SDV.CAN]Life Sciences [q-bio]/Cancer, General Medicine, Review, prostate cancer, Capivasertib, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, castration resistance, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [SDV.CAN] Life Sciences [q-bio]/Cancer, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Medicine
Abstract

International audience; Deregulation of the PI3K-Akt-mTOR pathway plays a critical role in the development and progression of many cancers. In prostate cancer, evidence suggests that it is mainly driven by PTEN loss of function. For many years, the development of selective Akt inhibitors has been challenging. In recent phase II and III clinical trials, Ipatasertib and Capivasertib associated with androgen deprivation therapies showed promising outcomes in patients with metastatic castration-resistant prostate cancer and PTEN-loss. Ongoing trials are currently assessing several Akt inhibitors in prostate cancer with different combinations, at different stages of the disease.

Published
2021

17. Oncologic Impact and Safety of Pre-Operative Radiotherapy in Localized Prostate and Bladder Cancer: A Comprehensive Review from the Cancerology Committee of the Association Française d’Urologie

Author

Morgan Rouprêt, Guilhem Roubaud, Romain Mathieu, Gaëlle Fromont-Hankard, Yann Neuzillet, Gilles Créhange, Alain Ruffion, Jean-Baptiste Beauval, Raphaële Renard-Penna, Mathieu Gauthé, Guillaume Ploussard, Laurent Brureau, Gaelle Fiard, Charles Dariane, Paul Sargos, Stéphane Supiot, Eric Barret, Institut Bergonié [Bordeaux], UNICANCER, Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), Institut Curie [Paris], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut Mutualiste de Montsouris (IMM), Clinique La Croix du Sud, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), École des Hautes Études en Santé Publique [EHESP] (EHESP), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre pour l'innovation en cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Foch [Suresnes], Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Ciblage thérapeutique en Oncologie (EA3738), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Chard-Hutchinson, Xavier

Subjects
Cancer Research, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Context (language use), Review, preoperative, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, medicine, Radical surgery, education, RC254-282, radiotherapy, education.field_of_study, Bladder cancer, business.industry, neoadjuvant, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, prostate cancer, Primary tumor, 3. Good health, Review article, Radiation therapy, [SDV] Life Sciences [q-bio], Oncology, 030220 oncology & carcinogenesis, bladder cancer, Radiology, business
Abstract

Simple Summary Radiotherapy may have an interesting role of reinforcing the loco-regional control of cancer, in addition to surgery, when used as a preoperative treatment. This sequence has demonstrated its efficacy and safety in various malignancies, but no strong data exist in the era of uro-oncology. In this review article, we aim to highlight the potential usefulness of preoperative radiotherapy in prostate and muscle-invasive bladder cancer, aiming to enhance pathological response and local control and to prevent intraoperative tumor seeding. We also emphasize the need for further clinical studies assessing the functional safety of subsequent surgical procedures in a competitive context of new systemic agents that have proven to demonstrate a survival benefit in locally advanced urologic cancers. Abstract Preoperative radiotherapy (RT) is commonly used for the treatment of various malignancies, including sarcomas, rectal, and gynaecological cancers, but it is preferentially used as a competitive treatment to radical surgery in uro-oncology or as a salvage procedure in cases of local recurrence. Nevertheless, preoperative RT represents an attractive strategy to prevent from intraoperative tumor seeding in the operative field, to sterilize microscopic extension outside the organ, and to enhance the pathological and/or imaging tumor response rate. Several clinical works support this research field in uro-oncology. In this review article, we summarized the oncologic impact and safety of preoperative RT in localized prostate and muscle-invasive bladder cancer. Preliminary studies suggest that both modalities can be complementary as initial primary tumor treatments and that a pre-operative radiotherapy strategy could be beneficial in a well-defined population of patients who are at a very high-risk of local relapse. Future prospective trials are warranted to evaluate the oncologic benefit of such a combination of local treatments in addition to new life-prolonging systemic therapies, such as immunotherapy, and new generation hormone therapies. Moreover, the safety and the feasibility of salvage surgical procedures due to non-response or local recurrence after pelvic RT remain poorly evaluated in that context.

Published
2021

18. Potential Targets Other Than PSMA for Prostate Cancer Theranostics: A Systematic Review

Author

Mathieu Gauthé, Paul Sargos, Eric Barret, Gaëlle Fromont-Hankard, Jean-Baptiste Beauval, Laurent Brureau, Gilles Créhange, Raphaële Renard-Penna, Charles Dariane, Gaëlle Fiard, Romain Mathieu, Guilhem Roubaud, Alain Ruffion, Morgan Rouprêt, Guillaume Ploussard, on behalf of the CC-AFU, Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Bergonié [Bordeaux], UNICANCER, Institut Mutualiste de Montsouris (IMM), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Clinique La Croix du Sud, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Institut Curie [Paris], Service de radiologie polyvalente et oncologique, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'urologie [CHU Grenoble], CHU Pontchaillou [Rennes], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Service d'Oncologie Radiothérapie [CHU Pitié Salpétrière], Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), HAL-SU, Gestionnaire, Service de Radiologie Polyvalente et Oncologique = Service d'Imagerie Spécialisées et des Urgences [CHU Pitié-Salpêtrière] (SISU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Radiologie [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Review, urologic and male genital diseases, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Fibroblast activation protein, alpha, medicine, Radioligand, therapeutics, nuclear medicine, Receptor, Urokinase Plasminogen Activator Surface Receptor, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Somatostatin receptor, business.industry, General Medicine, medicine.disease, molecular imaging, 3. Good health, Androgen receptor, 030220 oncology & carcinogenesis, Cancer research, Medicine, Molecular imaging, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background: Prostate-specific membrane antigen (PSMA) is not sufficiently overexpressed in a small proportion of prostate cancer (PCa) patients, who require other strategies for imaging and/or treatment. We reviewed potential targets other than PSMA for PCa theranostics in nuclear medicine that have already been tested in humans. Methods: We performed a systematic web search in the PubMed and Cochrane databases, with no time restrictions by pooling terms (“prostate cancer”, “prostatic neoplasms”) and (“radioligand”, “radiotracer”). Included articles were clinical studies. The results were synthetized by the target type. Results: We included 38 studies on six different targets: gastrin-releasing peptide receptors (GRPRs) (n = 23), androgen receptor (n = 11), somatostatin receptors (n = 6), urokinase plasminogen activator surface receptor (n = 4), fibroblast activation protein (n = 2 studies) and integrin receptors (n = 1). GRPRs, the most studied target, has a lower expression in high-grade PCa, CRPC and bone metastases. Its use might be of higher interest in treating earlier stages of PCa or low-grade PCa. Radiolabeled fibroblast activation protein inhibitors were the most recent and promising molecules, but specific studies reporting their interest in PCa are needed. Conclusion: Theranostics in nuclear medicine will continue to develop in the future, especially for PCa patients. Targets other than PSMA exist and deserve to be promoted.

Published
2021

19. Challenge of prostate MRI segmentation on T2-weighted images: inter-observer variability and impact of prostate morphology

Author

Nicholas Ayache, Hervé Delingette, Malek Ezziane, Dimitri Hamzaoui, Raphaële Renard-Penna, Mehdi Kalai, Sarah Montagne, Anna Luzurier, Raphaelle Quint, Alexandre Allera, Service de Radiologie [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Radiologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], E-Patient : Images, données & mOdèles pour la médeciNe numériquE (EPIONE), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Groupe de Recherche Clinique Onco-Urologie Prédictive [CHU Tenon] (GRC 5), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), ANR-19-P3IA-0002,3IA@cote d'azur,3IA Côte d'Azur(2019), ANR-17-EURE-0004,UCA DS4H,UCA Systèmes Numériques pour l'Homme(2017), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de Recherche Clinique Onco-Urologie Prédictive (GRC 5), Sorbonne Université (SU), PAIMRI, and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)

Subjects
R895-920, 030232 urology & nephrology, 030218 nuclear medicine & medical imaging, Medical physics. Medical radiology. Nuclear medicine, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Segmentation, Prostate, medicine, [SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Radiology, Nuclear Medicine and imaging, Neuroradiology, medicine.diagnostic_test, business.industry, Ultrasound, Zones, Magnetic resonance imaging, medicine.disease, Lobe, Intensity (physics), medicine.anatomical_structure, Original Article, Atlas, Nuclear medicine, business, MRI
Abstract

Background Accurate prostate zonal segmentation on magnetic resonance images (MRI) is a critical prerequisite for automated prostate cancer detection. We aimed to assess the variability of manual prostate zonal segmentation by radiologists on T2-weighted (T2W) images, and to study factors that may influence it. Methods Seven radiologists of varying levels of experience segmented the whole prostate gland (WG) and the transition zone (TZ) on 40 axial T2W prostate MRI images (3D T2W images for all patients, and both 3D and 2D images for a subgroup of 12 patients). Segmentation variabilities were evaluated based on: anatomical and morphological variation of the prostate (volume, retro-urethral lobe, intensity contrast between zones, presence of a PI-RADS ≥ 3 lesion), variation in image acquisition (3D vs 2D T2W images), and reader’s experience. Several metrics including Dice Score (DSC) and Hausdorff Distance were used to evaluate differences, with both a pairwise and a consensus (STAPLE reference) comparison. Results DSC was 0.92 (± 0.02) and 0.94 (± 0.03) for WG, 0.88 (± 0.05) and 0.91 (± 0.05) for TZ respectively with pairwise comparison and consensus reference. Variability was significantly (p p p Conclusions Variability is higher in the extreme parts of the gland, is influenced by changes in prostate morphology (volume, zone intensity ratio), and is relatively unaffected by the radiologist’s level of expertise.

Published
2021

20. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study

Author

Athivada Soto Thammavong, Raphaële Renard-Penna, Gilles Pasticier, Jean-Philippe Fendler, Flavie Bratan, Romain Boutier, Hervé Lang, Pascal Eschwege, Jochen Walz, Arnault Viller, Myriam Decaussin-Petrucci, Alain Ruffion, Nicolas Barry Delongchamps, Y. Lebras, François Cornud, Pierre Mozer, Jean-Michel Correas, Olivier Rouvière, Laurent Lemaitre, Michel Claudon, Paul C. Moldovan, Marine Dubreuil-Chambardel, Fanny Cros, Pierre Colin, Bernard Malavaud, Sebastien Crouzet, Hocine Habchi, Ahmed Khairoune, F Lefèvre, Anne-Marie Schott, Nicolas Grenier, G. Pagnoux, S. Brunelle, Marc Colombel, Laurent Magaud, Laurent Remontet, Philippe Camparo, Philippe Puech, François Cornelis, Florence Mège-Lechevallier, Muriel Rabilloud, Pierre Nevoux, E. Potiron, Daniel Portalez, Marc-Olivier Timsit, Nicolas Mottet, Gaelle Fiard, Jean-Luc Descotes, Catherine Roy, Philippe Hallouin, Hospices Civils de Lyon (HCL), Therapies Interventionnelles Assistees Par l'Image et la Simulation, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Lille, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Strasbourg, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Service de Biostatistiques [Lyon], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon], Centre Léon Bérard [Lyon], Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre de recherche cerveau et cognition (CERCO), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Imagerie moléculaire et fonctionnelle: de la physiologie à la thérapie, Université Bordeaux Segalen - Bordeaux 2-IFR8-Centre National de la Recherche Scientifique (CNRS), Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon, Departement de Neurologie (HCL), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), CHU Amiens-Picardie, Service de radiologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Bordeaux (UB), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier Saint Joseph - Saint Luc [Lyon], Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Necker - Enfants Malades [AP-HP], Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Bordeaux [Bordeaux], Centre d'Energétique et de Thermique de Lyon (CETHIL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'Hématologie [IUCT Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Lille 2 - Faculté de Médecine, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Therapies Interventionnelles Assistees Par l'Image et la Simulation - U 703 (Thiais), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), MRI-FIRST Investigators: Nicolas Barry Delongchamps, Romain Boutier, Flavie Bratan, Serge Brunelle, Philippe Camparo, Pierre Colin, Jean-Michel Corréas, François Cornélis, François Cornud, Fanny Cros, Jean-Luc Descotes, Pascal Eschwege, Gaelle Fiard, Jean-Philippe Fendler, Hocine Habchi, Philippe Hallouin, Ahmed Khairoune, Hervé Lang, Yann Lebras, Frédéric Lefèvre, Bernard Malavaud, Paul Cezar Moldovan, Nicolas Mottet, Pierre Mozer, Pierre Nevoux, Gaele Pagnoux, Gilles Pasticier, Daniel Portalez, Eric Potiron, Athivada Soto Thammavong, Marc-Olivier Timsit, Arnault Viller, Jochen Walz, Thérapies Laser Assistées par l'Image pour l'Oncologie (ONCO-THAI), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université de Lorraine (UL), Centre de Recherche en Cancérologie de Lyon (CRCL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service d'Urologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), and CCSD, Accord Elsevier

Subjects
Adult, Image-Guided Biopsy, Male, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Prostatitis, Young Adult, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, Biopsy, medicine, Humans, Prospective Studies, Multiparametric Magnetic Resonance Imaging, Stage (cooking), Prospective cohort study, Ultrasonography, Interventional, Aged, medicine.diagnostic_test, Urinary retention, business.industry, Prostatic Neoplasms, Cancer, Middle Aged, Prostate-Specific Antigen, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Radiology, medicine.symptom, business
Abstract

Summary Background Whether multiparametric MRI improves the detection of clinically significant prostate cancer and avoids the need for systematic biopsy in biopsy-naive patients remains controversial. We aimed to investigate whether using this approach before biopsy would improve detection of clinically significant prostate cancer in biopsy-naive patients. Methods In this prospective, multicentre, paired diagnostic study, done at 16 centres in France, we enrolled patients aged 18–75 years with prostate-specific antigen concentrations of 20 ng/mL or less, and with stage T2c or lower prostate cancer. Eligible patients had been referred for prostate multiparametric MRI before a first set of prostate biopsies, with a planned interval of less than 3 months between MRI and biopsies. An operator masked to multiparametric MRI results did a systematic biopsy by obtaining 12 systematic cores and up to two cores targeting hypoechoic lesions. In the same patient, another operator targeted up to two lesions seen on MRI with a Likert score of 3 or higher (three cores per lesion) using targeted biopsy based on multiparametric MRI findings. Patients with negative multiparametric MRI (Likert score ≤2) had systematic biopsy only. The primary outcome was the detection of clinically significant prostate cancer of International Society of Urological Pathology grade group 2 or higher (csPCa-A), analysed in all patients who received both systematic and targeted biopsies and whose results from both were available for pathological central review, including patients who had protocol deviations. This study is registered with ClinicalTrials.gov, number NCT02485379, and is closed to new participants. Findings Between July 15, 2015, and Aug 11, 2016, we enrolled 275 patients. 24 (9%) were excluded from the analysis. 53 (21%) of 251 analysed patients had negative (Likert ≤2) multiparametric MRI. csPCa-A was detected in 94 (37%) of 251 patients. 13 (14%) of these 94 patients were diagnosed by systematic biopsy only, 19 (20%) by targeted biopsy only, and 62 (66%) by both techniques. Detection of csPCa-A by systematic biopsy (29·9%, 95% CI 24·3–36·0) and targeted biopsy (32·3%, 26·5–38·4) did not differ significantly (p=0·38). csPCa-A would have been missed in 5·2% (95% CI 2·8–8·7) of patients had systematic biopsy not been done, and in 7·6% (4·6–11·6) of patients had targeted biopsy not been done. Four grade 3 post-biopsy adverse events were reported (3 cases of prostatitis, and 1 case of urinary retention with haematuria). Interpretation There was no difference between systematic biopsy and targeted biopsy in the detection of ISUP grade group 2 or higher prostate cancer; however, this detection was improved by combining both techniques and both techniques showed substantial added value. Thus, obtaining a multiparametric MRI before biopsy in biopsy-naive patients can improve the detection of clinically significant prostate cancer but does not seem to avoid the need for systematic biopsy. Funding French National Cancer Institute.

Published
2019

21. Reliability of Serial Prostate Magnetic Resonance Imaging to Detect Prostate Cancer Progression During Active Surveillance: A Systematic Review and Meta-analysis

Author

David D'Andrea, Benjamin Pradere, Guillaume Ploussard, Nicolai A. Huebner, Michael S. Leapman, Pawel Rajwa, Shahrokh F. Shariat, Keiichiro Mori, Aleksandra Krzywon, Pascal A. T. Baltzer, Raphaële Renard-Penna, Sung Ryul Shim, Ekaterina Laukhtina, Fahad Quhal, Medizinische Universität Wien = Medical University of Vienna, The Jikei University School of Medicine, Sechenov First Moscow State Medical University, Maria Sklodowska-Curie National Research Institute of Oncology, Yonsei University College of Medicine [Seoul, Republic of Korea], Service de Radiothérapie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Yale University School of Medicine, Weill Medical College of Cornell University [New York], University of Texas Southwestern Medical Center [Dallas], Charles University [Prague] (CU), Clinique La Croix du Sud, Service d'Oncologie Radiothérapie [CHU Pitié Salpétrière], CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Image-Guided Biopsy, Male, medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Urology, Biopsy, 030232 urology & nephrology, Context (language use), [SDV.CAN]Life Sciences [q-bio]/Cancer, Active surveillance, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Magnetic resonance imaging, Prostate, Medicine, Humans, Watchful Waiting, Reliability (statistics), medicine.diagnostic_test, business.industry, Prostatic Neoplasms, Reproducibility of Results, medicine.disease, Confidence interval, 3. Good health, Upgrading, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Meta-analysis, Disease Progression, Radiology, business
Abstract

Context Although magnetic resonance imaging (MRI) is broadly implemented into active surveillance (AS) protocols, data on the reliability of serial MRI in order to help guide follow-up biopsy are inconclusive. Objective To assess the diagnostic estimates of serial prostate MRI for prostate cancer (PCa) progression during AS. Evidence acquisition We systematically searched PubMed, Scopus, and Web of Science databases to select studies analyzing the association between changes on serial prostate MRI and PCa progression during AS. We included studies that provided data for MRI progression, which allowed us to calculate diagnostic estimates. We compared Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) accuracy with institution-specific definitions. Evidence synthesis We included 15 studies with 2240 patients. Six used PRECISE criteria and nine institution-specific definitions of MRI progression. The pooled PCa progression rate, which included histological progression to Gleason grade ≥2, was 27%. The pooled sensitivity and specificity were 0.59 (95% confidence interval [CI] 0.44–0.73) and 0.75 (95% CI 0.66–0.84) respectively. There was significant heterogeneity between included studies. Depending on PCa progression prevalence, the pooled negative predictive value for serial prostate MRI ranged from 0.81 (95% CI 0.73–0.88) to 0.88 (95% CI 0.83–0.93) and the pooled positive predictive value ranged from 0.37 (95% CI 0.24–0.54) to 0.50 (95% CI 0.36–0.66). There were no significant differences in the pooled sensitivity (p = 0.37) and specificity (p = 0.74) of PRECISE and institution-specific schemes. Conclusions Serial MRI still should not be considered a sole factor for excluding PCa progression during AS, and changes on MRI are not accurate enough to indicate PCa progression. There was a nonsignificant trend toward improved diagnostic estimates of PRECISE recommendations. These findings highlight the need to further define the optimal triggers and timing of biopsy during AS, as well as the need for optimizing the quality, interpretation, and reporting of serial prostate MRI. Patient summary Our study suggests that serial prostate magnetic resonance imaging (MRI) alone in patients on active surveillance is not accurate enough to reliably rule out or rule in prostate cancer progression. Other clinical factors and biomarkers along with serial MRI are required to safely tailor the intensity of follow-up biopsies.

Published
2021

22. Biomarker in Active Surveillance for Prostate Cancer: A Systematic Review

Author

Cécile, Manceau, Gaëlle, Fromont, Jean-Baptiste, Beauval, Eric, Barret, Laurent, Brureau, Gilles, Créhange, Charles, Dariane, Gaëlle, Fiard, Mathieu, Gauthé, Romain, Mathieu, Raphaële, Renard-Penna, Guilhem, Roubaud, Alain, Ruffion, Paul, Sargos, Morgan, Rouprêt, Guillaume, Ploussard, On Behalf Of The Cc-Afu Cancerology Committee Of The Association Française d'Urologie, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Clinique La Croix du Sud, Institut Mutualiste de Montsouris (IMM), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Institut Curie [Paris], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Radiologie [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Institut Bergonié [Bordeaux], UNICANCER, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre pour l'innovation en cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Groupe de Recherche Clinique Onco-Urologie Prédictive [CHU Tenon] (GRC 5), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Urologie [CHU Pitié-Salpêtrière], Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), HAL-SU, Gestionnaire, CHU Toulouse [Toulouse], Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Ciblage thérapeutique en Oncologie (EA3738), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Cancer Research, medicine.medical_specialty, 030232 urology & nephrology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, medicine, Tissue biomarkers, [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], Intensive care medicine, Prospective cohort study, [SDV.BBM.BC] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], RC254-282, Modalities, tissue biomarker, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, active surveillance, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, prostate cancer, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Biomarker (medicine), biomarker, urine biomarker, Personalized medicine, Systematic Review, blood biomarker, business, Outcome prediction, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Simple Summary Recently, biomarkers have become a supplemental tool to aid in the diagnosis and evaluation of prostate cancer. Numerous biomarkers are being developed, but no one has a place in current clinical practice for active surveillance. However, active surveillance is a curative treatment option that shifts the possible timing of treatment, but misclassification and progression impose regular monitoring of patients that could be improve by biomarkers. The aim of this review is to investigate the potential of biomarker performance for active surveillance selection and outcome prediction. Our study has identified the critical role that biomarkers could play in piecing together an individualised prognostic for each patient and their use in active surveillance. Although no single biomarker should determine therapy, each biomarker should be considered as a piece of the puzzle in the important decision-making process. Abstract Active surveillance (AS) in prostate cancer (PCa) represents a curative alternative for men with localised low-risk PCa. Continuous improvement of AS patient’s selection and surveillance modalities aims at reducing misclassification, simplifying modalities of surveillance and decreasing need for invasive procedures such repeated biopsies. Biomarkers represent interesting tools to evaluate PCa diagnosis and prognosis, of which many are readily available or under evaluation. The aim of this review is to investigate the biomarker performance for AS selection and patient outcome prediction. Blood, urinary and tissue biomarkers were studied and a brief description of use was proposed along with a summary of major findings. Biomarkers represent promising tools which could be part of a more tailored risk AS strategy aiming to offer personalized medicine and to individualize the treatment and monitoring of each patient. The usefulness of biomarkers has mainly been suggested for AS selection, whereas few studies have investigated their role during the monitoring phase. Randomized prospective studies dealing with imaging are needed as well as larger prospective studies with long-term follow-up and strong oncologic endpoints.

Published
2021

23. Robust Fusion of Probability Maps

Author

Benoît Audelan, Raphaële Renard-Penna, Hervé Delingette, Sarah Montagne, Dimitri Hamzaoui, E-Patient : Images, données & mOdèles pour la médeciNe numériquE (EPIONE), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), PAIMRI, ANR-15-IDEX-0001,UCA JEDI,Idex UCA JEDI(2015), ANR-19-P3IA-0002,3IA@cote d'azur,3IA Côte d'Azur(2019), Service de Radiologie Polyvalente Diagnostique et Interventionnelle [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)

Subjects
Boosting (machine learning), Computer science, business.industry, Deep learning, education, [INFO.INFO-CV]Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], Pattern recognition, Statistical model, Image segmentation, Sensor fusion, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Prior probability, Outlier, Segmentation, Artificial intelligence, business, 030217 neurology & neurosurgery
Abstract

International audience; The fusion of probability maps is required when trying to analyse a collection of image labels or probability maps produced by several segmentation algorithms or human raters. The challenge is to weight properly the combination of maps in order to reflect the agreement among raters, the presence of outliers and the spatial uncertainty in the consensus. In this paper, we address several shortcomings of prior work in continuous label fusion. We introduce a novel approach to jointly estimate a reliable consensus map and assess the production of outliers and the confidence in each rater. Our probabilistic model is based on Student's t-distributions allowing local estimates of raters' performances. The introduction of bias and spatial priors leads to proper rater bias estimates and a control over the smoothness of the consensus map. Image intensity information is incorporated by geodesic distance transform for binary masks. Finally, we propose an approach to cluster raters based on variational boosting thus producing possibly several alternative consensus maps. Our approach was successfully tested on the MICCAI 2016 MS lesions dataset, on MR prostate delineations and on deep learning based segmentation predictions of lung nodules from the LIDC dataset.

Published
2020

24. Diagnosis of prostate cancer in one day: The benefits of cytology in tumour detection

Author

V. Ondet, Raphaële Renard-Penna, Geraldine Cancel-Tassin, Eva Compérat, Olivier Cussenot, Groupe Hospitalier Diaconesses Croix Saint-Simon, Service de Pathologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de Recherche Clinique Onco-Urologie Prédictive [CHU Tenon] (GRC 5), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Radiologie Polyvalente Diagnostique et Interventionnelle [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), and Service d'urologie [CHU Tenon]

Subjects
Male, medicine.medical_specialty, Histology, Concordance, Cytodiagnosis, 030209 endocrinology & metabolism, urologic and male genital diseases, Stain, Pathology and Forensic Medicine, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, TUMOUR DETECTION, Cytology, medicine, Biomarkers, Tumor, Humans, Imprint cytology, p63, immunocytology, business.industry, racemase, Tumor Suppressor Proteins, Biopsy, Needle, Prostatic Neoplasms, General Medicine, Middle Aged, medicine.disease, 3. Good health, DNA-Binding Proteins, medicine.anatomical_structure, 030220 oncology & carcinogenesis, cytology, Radiology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Transcription Factors
Abstract

International audience; ObjectiveProstate cancer (PCa) is a frequent and mortal disease. The aim of this study was to introduce a “diagnosis and handling of PCa in one day” concept, accelerating the handling of PCa patients by giving diagnostic results within 3 hours with the help of prostate cytology. Standard histology served as the control.Material and methodsAfter multiparametric MRI, prostate biopsies were taken and one was used for imprint cytology on superfrost slides. The cytology samples were stained by p63/p504s double staining, a standard stain in PCa histology, followed by on‐site interpretation.ResultsAmong 129 patients, 39.5% had a prior history of PCa and were either under active surveillance or had been treated by focal therapy. The others came with suspicion of PCa. In 80.8% of the cases, the cytology and histology results agreed. In low‐grade PCa the detection with cytology was more difficult with 72.4% agreement, whereas for intermediate and high‐grade PCa the concordance with histology was 81.8 and 90%, respectively. False positive cases were less than 4.0%.ConclusionCytology of the prostate is unusual, but our study is the first to show it is feasible and gives immediate results that are satisfactory, especially in more aggressive cases. Immunocytology can be easily integrated into the laboratory. Our technique allows quicker handling of PCa, which can soften the psychological impact on men waiting for the diagnosis of PCa.

Published
2020

25. Assessment of the Minimal Targeted Biopsy Core Number per MRI Lesion for Improving Prostate Cancer Grading Prediction

Author

Mathieu Roumiguié, Jean-Baptiste Beauval, Christophe Tollon, Ambroise Salin, Christophe Almeras, Guillaume Ploussard, Guillaume Loison, Marine Lesourd, Jean-Romain Gautier, Bernard Malavaud, Daniel Portalez, Cécile Manceau, Raphaële Renard-Penna, and Michel Soulié

Subjects
targeted biopsies, medicine.medical_treatment, Concordance, 030232 urology & nephrology, lcsh:Medicine, Article, Lesion, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, Biopsy, medicine, biopsy, Grading (tumors), upgrading, medicine.diagnostic_test, Prostatectomy, business.industry, lcsh:R, General Medicine, medicine.disease, prostate cancer, radical prostatectomy, systematic biopsies, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Cohort, medicine.symptom, Nuclear medicine, business, fusion biopsies, MRI
Abstract

Background: To study the impact of MRI characteristics and of targeted biopsy (TB) core number on the final grade group (GG) prediction. Materials and Methods: The cohort was 478 consecutive patients who underwent radical prostatectomy (RP) after positive mpMRI (multiparametric magnetic resonance imaging) followed by fusion TB. Endpoints were the upgrading and concordance rates between TB and RP specimens. Results: Upgrading rate after TB was 40.6%. Patients with upgrading had lower PIRADS (Prostate Imaging-Reporting and Data System) scores (p &lt, 0.001), smaller lesion size (p = 0.017), fewer TB cores (p &lt, 0.001), and lower TB density (p = 0.015) compared with cases with grade concordance. There was a significant continuous improvement in upgrading rate when TB core number per lesion increased from 56.3% to 25.6% when &lt, 2 or &ge, 5 TB cores were taken, respectively (p = 0.002). The minimal TB number per lesion to reduce upgrading risk to approximately 30%was 4 in PIRADS 3, and 3 in PIRADS 4&ndash, 5 cases. Conclusions: Grade group prediction by TB is significantly improved by higher PIRADS score, larger lesion size, and increased TB per lesion. At least four TB cores should be taken in PIRADS 3 score lesions, whereas three cores seem enough in PIRADS 4&ndash, 5 cases to improve GG prediction and limit upgrading risk.

Published
2020
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26. EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study)

Author

Niall F. Davis, Muhammad Imran Omar, Alberto Briganti, Olivier Rouvière, James N'Dow, Ann Henry, Brett Cox, James W.F. Catto, Derya Tilki, Christopher J.D. Wallis, Maurizio Colecchia, Silke Gillessen, Steven MacLennan, Murali Varma, Thomas Van den Broeck, Philip Cornford, Susanne Vahr Lauridsen, J.P. Michiel Sedelaar, Nicola Fossati, Michael Lardas, Gemma Sancho Pardo, Paolo Dell'Oglio, André Deschamps, Nicolas Mottet, Lisa Moris, Marcus G. Cumberbatch, Thomas Wiegel, Raphaële Renard-Penna, Fabio Zattoni, James Donaldson, Phillip D. Stricker, Matthew Liew, Ivo G. Schoots, Stefano Fanti, Theodorus H. van der Kwast, Geert J.L.H. van Leenders, Nikolaos Grivas, Monique J. Roobol, Erik Briers, Hendrik Van Poppel, Karin Plass, Jeff Davies, Jonathan Richenberg, Maria De Santis, Jacques Irani, Daniel W. Lin, Shin Egawa, Tobias Gross, Peter Paul M. Willemse, Roderick C.N. van den Bergh, Alberto Bossi, Henk G. van der Poel, Chris H. Bangma, Maria J. Ribal, Giorgio Gandaglia, Alexandre Ingels, Karl H. Pang, Morgan Rouprêt, Robert Shepherd, Jeremy Grummet, Thomas B. Lam, Malcolm David Mason, Catherine Paterson, Karel Tim Buddingh, Christian D. Fankhauser, Ruud Baanders, Anders Bjartell, Philippe D. Violette, Karen Wilkinson, Lam, T. B. L., Maclennan, S., Willemse, P. -P. M., Mason, M. D., Plass, K., Shepherd, R., Baanders, R., Bangma, C. H., Bjartell, A., Bossi, A., Briers, E., Briganti, A., Buddingh, K. T., Catto, J. W. F., Colecchia, M., Cox, B. W., Cumberbatch, M. G., Davies, J., Davis, N. F., De Santis, M., Dell'Oglio, P., Deschamps, A., Donaldson, J. F., Egawa, S., Fankhauser, C. D., Fanti, S., Fossati, N., Gandaglia, G., Gillessen, S., Grivas, N., Gross, T., Grummet, J. P., Henry, A. M., Ingels, A., Irani, J., Lardas, M., Liew, M., Lin, D. W., Moris, L., Omar, M. I., Pang, K. H., Paterson, C. C., Renard-Penna, R., Ribal, M. J., Roobol, M. J., Roupret, M., Rouviere, O., Sancho Pardo, G., Richenberg, J., Schoots, I. G., Sedelaar, J. P. M., Stricker, P., Tilki, D., Vahr Lauridsen, S., van den Bergh, R. C. N., Van den Broeck, T., van der Kwast, T. H., van der Poel, H. G., van Leenders, G. J. L. H., Varma, M., Violette, P. D., Wallis, C. J. D., Wiegel, T., Wilkinson, K., Zattoni, F., N'Dow, J. M. O., Van Poppel, H., Cornford, P., Mottet, N., Urology, Radiology & Nuclear Medicine, Pathology, and Lam TBL, MacLennan S, Willemse PM, Mason MD, Plass K, Shepherd R, Baanders R, Bangma CH, Bjartell A, Bossi A, Briers E, Briganti A, Buddingh KT, Catto JWF, Colecchia M, Cox BW, Cumberbatch MG, Davies J, Davis NF, De Santis M, Dell'Oglio P, Deschamps A, Donaldson JF, Egawa S, Fankhauser CD, Fanti S, Fossati N, Gandaglia G, Gillessen S, Grivas N, Gross T, Grummet JP, Henry AM, Ingels A, Irani J, Lardas M, Liew M, Lin DW, Moris L, Omar MI, Pang KH, Paterson CC, Renard-Penna R, Ribal MJ, Roobol MJ, Rouprêt M, Rouvière O, Sancho Pardo G, Richenberg J, Schoots IG, Sedelaar JPM, Stricker P, Tilki D, Vahr Lauridsen S, van den Bergh RCN, Van den Broeck T, van der Kwast TH, van der Poel HG, van Leenders GJLH, Varma M, Violette PD, Wallis CJD, Wiegel T, Wilkinson K, Zattoni F, N'Dow JMO, Van Poppel H, Cornford P, Mottet N.

Subjects
Male, medicine.medical_specialty, Localised prostate cancer, Urology, education, 030232 urology & nephrology, Delphi method, Reclassification, Outcome measures, Time-to-Treatment, Outcome measure, 03 medical and health sciences, Prostate cancer, Active surveillance and monitoring, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Consensus group meeting, Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15], medicine, Humans, 610 Medicine & health, Clinical practice guideline, Curative intent, Clinical Oncology, Eligibility, business.industry, Follow-up, Prostatic Neoplasms, Consensus statements, Guideline, Deferred treatment with curative intent, medicine.disease, Clinical practice guidelines, Delphi survey, Deferred treatment, Consensus statement, 030220 oncology & carcinogenesis, Family medicine, business
Abstract

Background: There is uncertainty in deferred active treatment (DAT) programmes, regarding patient selection, follow-up and monitoring, reclassification, and which outcome measures should be prioritised. Objective: To develop consensus statements for all domains of DAT. Design, setting, and participants: A protocol-driven, three phase study was undertaken by the European Association of Urology (EAU)-European Association of Nuclear Medicine (EANM)-European Society for Radiotherapy and Oncology (ESTRO)-European Association of Urology Section of Urological Research (ESUR)-International Society of Geriatric Oncology (SIOG) Prostate Cancer Guideline Panel in conjunction with partner organisations, including the following: (1) a systematic review to describe heterogeneity across all domains; (2) a two-round Delphi survey involving a large, international panel of stakeholders, including healthcare practitioners (HCPs) and patients; and (3) a consensus group meeting attended by stakeholder group representatives. Robust methods regarding what constituted the consensus were strictly followed. Results and limitations: A total of 109 HCPs and 16 patients completed both survey rounds. Of 129 statements in the survey, consensus was achieved in 66 (51%); the rest of the statements were discussed and voted on in the consensus meeting by 32 HCPs and three patients, where consensus was achieved in additional 27 statements (43%). Overall, 93 statements (72%) achieved consensus in the project. Some uncertainties remained regarding clinically important thresholds for disease extent on biopsy in low-risk disease, and the role of multiparametric magnetic resonance imaging in determining disease stage and aggressiveness as a criterion for inclusion and exclusion. Conclusions: Consensus statements and the findings are expected to guide and inform routine clinical practice and research, until higher levels of evidence emerge through prospective comparative studies and clinical trials. Patient summary: We undertook a project aimed at standardising the elements of practice in active surveillance programmes for early localised prostate cancer because currently there is great variation and uncertainty regarding how best to conduct them. The project involved large numbers of healthcare practitioners and patients using a survey and face-to-face meeting, in order to achieve agreement (ie, consensus) regarding best practice, which will provide guidance to clinicians and researchers. (C) 2019 Published by Elsevier B.V. on behalf of European Association of Urology.

Published
2019

27. Update on the ICUD-SIU consultation on multi-parametric magnetic resonance imaging in localised prostate cancer

Author

Matthieu Durand, Valeria Panebianco, Raphaële Renard-Penna, Philippe Puech, Olivier Rouvière, Baris Turkbey, Jurgen J. Fütterer, and Eric Barret

Subjects
Male, In vivo magnetic resonance spectroscopy, medicine.medical_specialty, Magnetic Resonance Spectroscopy, Urology, 030232 urology & nephrology, Contrast Media, 03 medical and health sciences, Prostate cancer, All institutes and research themes of the Radboud University Medical Center, 0302 clinical medicine, Prostate, Biopsy, multiparametric MRI, prostate, prostate cancer, prostate MRI, contrast media, diffusion magnetic resonance imaging, humans, magnetic resonance spectroscopy, male, neoplasm recurrence, local, prostatic neoplasms, magnetic resonance imaging, medicine, Humans, Image acquisition, Multi parametric, medicine.diagnostic_test, Repeat biopsy, business.industry, Prostatic Neoplasms, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Diffusion Magnetic Resonance Imaging, medicine.anatomical_structure, Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], 030220 oncology & carcinogenesis, Radiology, Neoplasm Recurrence, Local, business
Abstract

Prostate cancer (PCa) imaging is a rapidly evolving field. Dramatic improvements in prostate MRI during the last decade will probably change the accuracy of diagnosis. This chapter reviews recent current evidence about MRI diagnostic performance and impact on PCa management. The International Consultation on Urological Diseases nominated a committee to review the literature on prostate MRI. A search of the PubMed database was conducted to identify articles focussed on MP-MRI detection and staging protocols, reporting and scoring systems, the role of MP-MRI in diagnosing PCa prior to biopsy, in active surveillance, in focal therapy and in detecting local recurrence after treatment. Differences in opinion were reported in the use of the strength of magnets [1.5 Tesla (T) vs. 3T] and coils. More agreement was found regarding the choice of pulse sequences; diffusion-weighted MRI (DW-MRI), dynamic contrast-enhanced MRI (DCE MRI), and/or MR spectroscopy imaging (MRSI) are recommended in addition to conventional T2-weighted anatomical sequences. In 2015, the Prostate Imaging Reporting and Data System (PI-RADS version 2) was described to standardize image acquisition and interpretation. MP-MRI improves detection of clinically significant PCa (csPCa) in the repeat biopsy setting or before the confirmatory biopsy in patients considering active surveillance. It is useful to guide focal treatment and to detect local recurrences after treatment. Its role in biopsy-naive patients or during the course of active surveillance remains debated. MP-MRI is increasingly used to improve detection of csPCa and for the selection of a suitable therapeutic approach.

Published
2018

28. Reporting Magnetic Resonance Imaging in Men on Active Surveillance for Prostate Cancer: The PRECISE Recommendations-A Report of a European School of Oncology Task Force

Author

Jochen Walz, Baris Turkbey, Antti Rannikko, Clare Allen, Peter R. Carroll, Peter C. Albertsen, Alberto Briganti, Philippe Puech, Francesco Giganti, Peter A. Pinto, Anwar R. Padhani, Ivo G. Schoots, Caroline M. Moore, Masoom A. Haider, Laurence Klotz, Heinrik van Poppel, Alex Kirkham, Riccardo Valdagni, Veeru Kasivisvanathan, Valeria Panebianco, Adil Ouzzane, Raphaële Renard-Penna, Karim Touijer, Chris H. Bangma, Moore, Caroline M., Giganti, Francesco, Albertsen, Peter, Allen, Clare, Bangma, Chri, Briganti, Alberto, Carroll, Peter, Haider, Masoom, Kasivisvanathan, Veeru, Kirkham, Alex, Klotz, Laurence, Ouzzane, Adil, Padhani, Anwar R., Panebianco, Valeria, Pinto, Peter, Puech, Philippe, Rannikko, Antti, Renard-Penna, Raphaele, Touijer, Karim, Turkbey, Bari, van Poppel, Heinrik, Valdagni, Riccardo, Walz, Jochen, Schoots, Ivo, Urology, Radiology & Nuclear Medicine, Clinicum, Department of Surgery, Urologian yksikkö, and HUS Abdominal Center

Subjects
Male, medicine.medical_specialty, Consensus, Urology, Advisory Committees, 030232 urology & nephrology, Prostate MRI, Consensu, Active surveillance, Documentation, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, SDG 3 - Good Health and Well-being, medicine, Humans, Medical physics, Watchful Waiting, Case report form, Gynecology, prostate cancer, prostate MRI, advisory committees, consensus, documentation, Europe, humans, magnetic resonance imaging, male, oncology nursing, practice guidelines as topic, prostatic neoplasms, radiology, tumor burden, watchful waiting, Advisory Committee, Data collection, medicine.diagnostic_test, business.industry, Oncology Nursing, Cancer, Prostatic Neoplasms, Magnetic resonance imaging, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Magnetic Resonance Imaging, Checklist, 3. Good health, Tumor Burden, 030220 oncology & carcinogenesis, Radiological weapon, Cohort, Practice Guidelines as Topic, Prostatic Neoplasm, business, FOLLOW-UP, Radiology, MRI, Human
Abstract

Background: Published data on prostate magnetic resonance imaging (MRI) during follow-up of men on active surveillance are lacking. Current guidelines for prostate MRI reporting concentrate on prostate cancer (PCa) detection and staging. A standardised approach to prostate MRI reporting for active surveillance will facilitate the robust collection of evidence in this newly developing area. Objective: To develop preliminary recommendations for reporting of individual MRI studies in men on active surveillance and for researchers reporting the outcomes of cohorts of men having MRI on active surveillance. Design, setting, and participants: The RAND/UCLA Appropriateness Method was used. Experts in urology, radiology, and radiation oncology developed a set of 394 statements relevant to prostate MRI reporting in men on active surveillance for PCa. Each statement was scored for agreement on a 9-point scale by each panellist prior to a panel meeting. Each statement was discussed and rescored at the meeting. Outcome measurements and statistical analysis: Measures of agreement and consensus were calculated for each statement. The most important statements, derived from both group discussion and scores of agreement and consensus, were used to create the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) checklist and case report form. Results and limitations: Key recommendations include reporting the index lesion size using absolute values at baseline and at each subsequent MRI. Radiologists should assess the likelihood of true change over time (ie, change in size or change in lesion characteristics on one or more sequences) on a 1-5 scale. A checklist of items for reporting a cohort of men on active surveillance was developed. These items were developed based on expert consensus in many areas in which data are lacking, and they are expected to develop and change as evidence is accrued. Conclusions: The PRECISE recommendations are designed to facilitate the development of a robust evidence database for documenting changes in prostateMRI findings over time ofmen on active surveillance. If used, they will facilitate data collection to distinguish-measurement error and natural variability in MRI appearances from true radiologic progression. Patient summary: Few published reports are available on how to use and interpret magnetic resonance imaging for men on active surveillance for prostate cancer. The PRECISE panel recommends that data should be collected in a standardised manner so that natural variation in the appearance and measurement of cancer over time can be distinguished from changes indicating significant tumour progression. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Published
2017

29. Erratum to ‘Prostate cancer local staging using biparametric MRI: Assessment and comparison with multiparametric MRI’ [Eur. J. Radiol. 132 (2020) 109350]

Author

Morgan Rouprêt, Charlotte Christophe, Stéphanie Bourrelier, Sarah Montagne, Raphaële Renard-Penna, Olivier Lucidarme, Jean François Coté, François Rozet, Eva Compérat, Olivier Cussenot, Benjamin Granger, and Eric Barret

Subjects
medicine.medical_specialty, Prostate cancer, business.industry, Multiparametric MRI, Medicine, Radiology, Nuclear Medicine and imaging, General Medicine, Radiology, business, medicine.disease
Published
2020

30. Endocrine Manifestations in a Monocentric Cohort of 64 Patients With Erdheim-Chester Disease

Author

Z. Amoura, M. Leban, J. Haroche, S. Laugier Robiolle, F. Cohen Aubart, Frédéric Charlotte, Carine Courtillot, Raphaële Renard-Penna, Philippe Touraine, and Aurélie Drier

Subjects
Adult, Male, Erdheim-Chester Disease, medicine.medical_specialty, genetic structures, Endocrinology, Diabetes and Metabolism, Pituitary Function Tests, Clinical Biochemistry, 030209 endocrinology & metabolism, Disease, Thyroid Function Tests, Biochemistry, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Bone Density, Endocrine Glands, Internal medicine, Adrenal Glands, medicine, Humans, Endocrine system, Young adult, Gonads, Aged, Aged, 80 and over, business.industry, Biochemistry (medical), Middle Aged, medicine.disease, Histiocytosis, Erdheim–Chester disease, Cohort, Diabetes insipidus, Disease Progression, Female, France, business, Diabetes Insipidus, 030217 neurology & neurosurgery, Follow-Up Studies, Cohort study
Abstract

Erdheim-Chester disease (ECD) is a rare non-Langerhans cell histiocytosis, characterized by infiltration of foamy histiocytes in multiple organs. Endocrine involvement has mostly been described in case reports.We performed systematic endocrine evaluation in a large cohort of patients with ECD.This was a single-center observational study conducted between October 2007 and May 2013.The evaluation was conducted in Pitié-Salpêtrière Hospital (Paris, France), a tertiary care hospital.Sixty-four consecutive patients with ECD (sex ratio, 3.6; mean age, 57.6 years [range, 20-80 years]). Thirty-six patients had follow-up assessments.There were no interventions.Clinical, biological, and morphological evaluations of pituitary, gonadal, adrenal, and thyroid functions, as well as metabolic evaluation, were performed.Diabetes insipidus was found in 33.3% of patients, frequently as the first manifestation of ECD. Anterior pituitary dysfunction was found in 91.3% of patients with full anterior pituitary evaluation, including somatotropic deficiency (78.6%), hyperprolactinemia (44.1%), gonadotropic deficiency (22.2%), thyrotropic deficiency (9.5%), and corticotropic deficiency (3.1%). Thirty-five patients (54.7%) had ≥2 anterior pituitary dysfunctional axes, rising to 69.6% (16 of 23) when only patients with complete evaluations were considered. Two patients had panhypopituitarism. Infiltration of the pituitary and stalk was found with magnetic resonance imaging in 24.4% of patients. Testicular insufficiency was found in 53.1% of patients, with sonographic testicular infiltration in 29% of men, mostly bilateral. Computed tomography adrenal infiltration was found in 39.1% of patients, and 1 case of adrenal insufficiency was observed. No patient was free of endocrine hormonal or morphological involvement. Endocrine dysfunctions were most often permanent, and new deficits appeared during follow-up.Endocrine involvement is very frequent in ECD and should be evaluated carefully at diagnosis and during follow-up.

Published
2016

31. Diagnostic performance of chest computed tomography during the epidemic wave of COVID-19 varied as a function of time since the beginning of the confinement in France

Author

Olivier Lucidarme, Raphaële Renard-Penna, Joe-Elie Salem, Mathilde Wagner, Samia Boussouar, Victoria Donciu, Alban Redheuil, Stéphane Marot, Nicoletta Pasi, Yonathan Freund, Laboratoire d'Imagerie Biomédicale (LIB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Service de pharmacologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Urgences [CHU Pitié-Salpêtrière], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP]

Subjects
Male, Viral Diseases, Pulmonology, Epidemiology, COVID19, [SDV]Life Sciences [q-bio], Chest ct, Artificial Gene Amplification and Extension, Computed tomography, 030204 cardiovascular system & hematology, Polymerase Chain Reaction, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Diagnostic Radiology, 030218 nuclear medicine & medical imaging, Medical Conditions, 0302 clinical medicine, Medicine and Health Sciences, Tomography, Virus Testing, Aged, 80 and over, education.field_of_study, Multidisciplinary, medicine.diagnostic_test, Reverse Transcriptase Polymerase Chain Reaction, Radiology and Imaging, Middle Aged, Reference Standards, Prognosis, Pulmonary Imaging, 3. Good health, Infectious Diseases, Medicine, Female, France, Radiology, Research Article, Adult, medicine.medical_specialty, 2019-20 coronavirus outbreak, Adolescent, Coronavirus disease 2019 (COVID-19), Imaging Techniques, Science, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Population, Neuroimaging, Research and Analysis Methods, Sensitivity and Specificity, Infectious Disease Epidemiology, Young Adult, 03 medical and health sciences, Computed Tomography, Diagnostic Medicine, medicine, Humans, Molecular Biology Techniques, education, Molecular Biology, Pandemics, Aged, Retrospective Studies, SARS-CoV-2, business.industry, Biology and Life Sciences, COVID-19, Covid 19, Reverse Transcriptase-Polymerase Chain Reaction, Pneumonia, medicine.disease, Mass Chest X-Ray, Computed Axial Tomography, Pulmonary imaging, Tomography, X-Ray Computed, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Neuroscience
Abstract

Objective To evaluate the diagnostic performance of the initial chest CT to diagnose COVID-19 related pneumonia in a French population of patients with respiratory symptoms according to the time from the onset of country-wide confinement to better understand what could be the role of the chest CT in the different phases of the epidemic. Material and method Initial chest CT of 1064 patients with respiratory symptoms suspect of COVID-19 referred between March 18th, and May 12th 2020, were read according to a standardized procedure. The results of chest CTs were compared to the results of the RT-PCR. Results 546 (51%) patients were found to be positive for SARS-CoV2 at RT-PCR. The highest rate of positive RT-PCR was during the second week of confinement reaching 71.9%. After six weeks of confinement, the positive RT-PCR rate dropped significantly to 10.5% (p Conclusion At the peak of the epidemic, chest CT had sufficiently high sensitivity and PPV to serve as a first-line positive diagnostic tool but at the end of the epidemic wave CT is more useful to exclude COVID-19 pneumonia.

Published
2020

32. Editorial Comment: Advances in MRI and PET of the prostate: concurrence or complementarity?

Author

Jean-Noël Talbot, Mathieu Gauthé, and Raphaële Renard-Penna

Subjects
Male, medicine.medical_specialty, Biopsy, Population, Diagnostic evaluation, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, parasitic diseases, medicine, Humans, Radiology, Nuclear Medicine and imaging, Lymph node staging, education, Diffusion Kurtosis Imaging, Neuroradiology, education.field_of_study, business.industry, Prostatic Neoplasms, General Medicine, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Radiology, business, Tomography, X-Ray Computed
Abstract

This Editorial Comment refers to the articles “Diagnostic evaluation of magnetization transfer and diffusion kurtosis imaging for prostate cancer detection in a re-biopsy population” by Barrett T et al., Eur Radiol. 2017 Dec 8 and “18F-Fluciclovine PET/MRI for preoperative lymph node staging in high-risk prostate cancer patients” by Selnaes KM et al., Eur Radiol. 2018 Jan 2.

Published
2018

33. Characterization of small (4cm) solid renal masses by computed tomography and magnetic resonance imaging: Current evidence and further development

Author

Nicola Schieda, Robert S. Lim, Raphaële Renard-Penna, Matthew D. F. McInnes, Sebastian Tavolaro, I. Thomassin, and François Cornelis

Subjects
Adult, Male, Angiomyolipoma, Computed tomography, Chromophobe cell, urologic and male genital diseases, 030218 nuclear medicine & medical imaging, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Renal cell carcinoma, Medicine, Effective diffusion coefficient, Humans, Radiology, Nuclear Medicine and imaging, Carcinoma, Renal Cell, Aged, Aged, 80 and over, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Kidney Neoplasms, Tumor Burden, Homogeneous, 030220 oncology & carcinogenesis, Female, business, Nuclear medicine, Tomography, X-Ray Computed, Clear cell
Abstract

Diagnosis of renal cell carcinomas (RCC) subtypes on computed tomography (CT) and magnetic resonance imaging (MRI) is clinically important. There is increased evidence that confident imaging diagnosis is now possible while standardization of the protocols is still required. Fat-poor angiomyolipoma show homogeneously increased unenhanced attenuation, homogeneously low signal on T2-weighted MRI and apparent diffusion coefficient (ADC) map, may contain microscopic fat and are classically avidly enhancing. Papillary RCC are also typically hyperattenuating and of low signal on T2-weighted MRI and ADC map; however, their gradual progressive enhancement after intravenous administration of contrast material is a differentiating feature. Clear cell RCC are avidly enhancing and may show intracellular lipid; however, these tumors are heterogeneous and are of characteristically increased signal on T2-weighted MRI. Oncocytomas and chromophobe tumors (collectively oncocytic neoplasms) show intermediate imaging findings on CT and MRI and are the most difficult subtype to characterize accurately; however, both show intermediately increased signal on T2-weighted with more gradual enhancement compared to clear cell RCC. Chromophobe tumors tend to be more homogeneous compared to oncocytomas, which can be heterogeneous, but other described features (e.g. scar, segmental enhancement inversion) overlap considerably between tumors. Tumor grade is another important consideration in small solid renal masses with emerging studies on both CT and MRI suggesting that high grade tumors may be separated from lower grade disease based upon imaging features.

Published
2018

34. Prostate Cancer Diagnosis: Multiparametric MR-targeted Biopsy with Cognitive and Transrectal US–MR Fusion Guidance versus Systematic Biopsy—Prospective Multicenter Study

Author

Xavier Leroy, Olivier Rouvière, Adil Ouzzane, Eva Comperat, Florence Mège-Lechevallier, Raphaële Renard-Penna, Arnauld Villers, Marc Colombel, Laurent Lemaitre, Philippe Puech, Marc-Olivier Bitker, and Patrick Devos

Subjects
Male, medicine.medical_specialty, Biopsy, Targeted biopsy, Prostate cancer, Imaging, Three-Dimensional, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, Prospective cohort study, Systematic biopsy, Ultrasonography, Interventional, Aged, Chi-Square Distribution, medicine.diagnostic_test, business.industry, Prostatic Neoplasms, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Mr imaging, Multicenter study, France, Radiology, Ultrasonography, business, Software
Abstract

To compare biopsy performance of two approaches for multiparametric magnetic resonance (MR)-targeted biopsy (TB) with that of extended systematic biopsy (SB) in prostate cancer (PCa) detection.This institutional review board-approved multicenter prospective study (May 2009 to January 2011) included 95 patients with informed consent who were suspected of having PCa, with a suspicious abnormality (target) at prebiopsy MR. Patients underwent 12-core SB and four-core TB with transrectal ultrasonographic (US) guidance, with two cores aimed visually (cognitive TB [TB-COG]) and two cores aimed using transrectal US-MR fusion software (fusion-guided TB [TB-FUS]). SB and TB positivity for cancer and sampling quality (mean longest core cancer length, Gleason score) were compared. Clinically significant PCa was any 3 mm or greater core cancer length or any greater than 3 Gleason pattern for SB or any cancer length for TB. Statistical analysis included t test, paired χ(2) test, and κ statistic. Primary end point (core cancer length) was calculated (paired t test).Among 95 patients (median age, 65 years; mean prostate-specific antigen level, 10.05 ng/mL [10.05 μg/L]), positivity rate for PCa was 59% (n = 56) for SB and 69% (n = 66) for TB (P = .033); rate for clinically significant PCa was 52% (n = 49) for SB and 67% (n = 64) for TB (P = .0011). Cancer was diagnosed through TB in 16 patients (17%) with negative SB results. Mean longest core cancer lengths were 4.6 mm for SB and 7.3 mm for TB (P.0001). In 12 of 51 (24%) MR imaging targets with positive SB and TB results, TB led to Gleason score upgrading. In 79 MR imaging targets, positivity for cancer was 47% (n = 37) with TB-COG and 53% (n = 42) with TB-FUS (P = .16). Neither technique was superior for Gleason score assessment.Prebiopsy MR imaging combined with transrectal US-guided TB increases biopsy performance in detecting PCa, especially clinically significant PCa. No significant difference was observed between TB-FUS and TB-COG for TB guidance.

Published
2013

35. Current practice and access to prostate MR imaging in France

Author

Claude Borgogno, Catherine Roy, J. M. Correas, Michel Claudon, Philippe Puech, L. Abbas, G. Ploussard, S. Tezenas-Du-Montcel, Raphaële Renard-Penna, A. Mejean, Olivier Rouvière, François Rozet, Luc Cormier, Institut universitaire de cancérologie GRC5, Université Pierre et Marie Curie - Paris 6 (UPMC), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Department of Urinary and Vascular Radiology, Hospices Civils de Lyon (HCL), Thérapies Laser Assistées par l'Image pour l'Oncologie (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie [CH René Dubos Pontoise], Centre Hospitalier René Dubos [Pontoise], Service de Biostatistique Santé Publique et Information Médicale [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP], Service de radiologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Department of Adult Radiology, CHU Necker - Enfants Malades [AP-HP], UFR des Sciences de Santé (Université de Bourgogne), Université de Bourgogne (UB), Service d'Urologie [CHU Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Service d'urologie [Institut Mutualiste Montsouris], Institut Mutualiste de Montsouris (IMM), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Université Claude Bernard Lyon 1 ( UCBL ), Hospices Civils de Lyon ( HCL ), Thérapies Laser Assistées par l'Image pour l'Oncologie ( ONCO-THAI ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ) -Université de Lille, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ) -Université de Lorraine ( UL ), Université de Bourgogne ( UB ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Institut Mutualiste de Montsouris ( IMM ), Institut Universitaire de Cancérologie [Sorbonne Université] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 (ONCO-THAI), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Institut Universitaire de Cancérologie [Paris] (IUC), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Département de Biostatistique, Santé Publique et Information Médicale [CHU Pitié-Salpêtrière] (BIOSPIM ), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Adult, Male, medicine.medical_specialty, Waiting Lists, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, 030232 urology & nephrology, men, Recommendations, Health Services Accessibility, 030218 nuclear medicine & medical imaging, Endosonography, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Magnetic resonance imaging, Prostate, Surveys and Questionnaires, cancer diagnosis, Biopsy, Medicine, Humans, Radiology, Nuclear Medicine and imaging, biopsy, [ SDV.IB.IMA ] Life Sciences [q-bio]/Bioengineering/Imaging, Cancer staging, Neoplasm Staging, validation, volume, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Ultrasound, active surveillance, Prostatic Neoplasms, scoring system, General Medicine, Middle Aged, medicine.disease, Mr imaging, 3. Good health, medicine.anatomical_structure, Current practice, Radiology, France, business
Abstract

International audience; Purpose: To obtain an overview of the degree of discrepancy between current clinical practice of prostate magnetic resonance imaging (MRI) in France and recommendations.Materials and methods: A brief survey was sent to 1229 members of the French society of urology in order to identify their indications of prostate MRI and its impact on patient management. The urologists were asked to answer several questions regarding age, practice modality, prostate MRI examinations (technique, indication before first biopsy, second biopsy, cancer staging, active surveillance, recurrence, focal therapy) and quality of reports.Results: A total of 445 responses were received (participation rate of 36%). The mean delay for obtaining an appointment for prostate MRI ranged between 1530 days in 54%. Fifty-four percent of MRI reports contained a PIRADS score and 23% a Likert score. The indications of multiparametric-MRI were tumor detection/location prior to repeat biopsy (90%), cancer staging (85%), management of patients under active surveillance (85%), selection of candidates to focal therapy (63%), tumor detection/location in biopsy naive patients (53%), detection of local recurrence after radical (51%). Only 119 urologists (28.6%) had access to image fusion (MRI and transrectal ultrasound) and 351 (85.4%) used cognitive fusion. Mostly, targeted biopsies are done by urologists alone (nearly 80%), a very few are done by radiologists (8%) or by the two of them in collaboration (12%).Conclusion: The majority of urologists consider that prostate MRI is essential for the management of patients with prostate cancer. Practices are ahead of recommendations particularly before the first biopsy and in active surveillance.

Published
2016

36. Management of Node Only Recurrence after Primary Local Treatment for Prostate Cancer: A Systematic Review of the Literature

Author

Guillaume Ploussard, Vincent Flamand, Piet Ost, Raphaële Renard-Penna, Arnauld Villers, Thierry Lebret, Alexandre de la Taille, Alberto Briganti, Christophe Almeras, Michel Soulié, Ambroise Salin, Gianluca Giannarini, Christophe Hennequin, Ploussard, Guillaume, Almeras, Christophe, Briganti, Alberto, Giannarini, Gianluca, Hennequin, Christophe, Ost, Piet, Renard Penna, Raphaele, Salin, Ambroise, Lebret, Thierry, Villers, Arnauld, Soulie, Michel, de la Taille, Alexandre, and Flamand, Vincent

Subjects
Biochemical recurrence, Male, medicine.medical_specialty, medicine.medical_treatment, Urology, Salvage therapy, lymph node dissection, Androgen deprivation therapy, prostatic neoplasm, Prostate cancer, local, medicine, Humans, Lymph node, radiotherapy, Salvage Therapy, PET-CT, business.industry, Prostatic Neoplasms, Lymphatic Metastasi, medicine.disease, neoplasm recurrence, Surgery, Radiation therapy, medicine.anatomical_structure, Lymphatic Metastasis, Lymph Node Excision, Neoplasm Recurrence, Local, business, Radical retropubic prostatectomy, Human
Abstract

Purpose We analyzed all available studies assessing the management of node only recurrence after primary local treatment of prostate cancer. Materials and Methods We systematically reviewed the literature in January 2015 using the PubMed®, Web of Sciences and Embase® databases according to PRISMA guidelines. Studies exclusively reporting visceral or bone metastatic disease were excluded from analysis. Eight radiotherapy and 12 salvage lymph node dissection series were included in our qualitative study. Results All 248 radiotherapy and 480 salvage lymph node dissection studies were single arm case series including a total of 728 patients. Choline positron emission tomography/computerized tomography was the reference imaging technique for nodal recurrence detection. Globally 50% of patients remained disease-free after short-term followup. Nevertheless, approximately two-thirds of patients received adjuvant hormone therapy, leading an overestimation of prostate specific antigen-free survival rates obtained after salvage treatment. Combining radiotherapy with salvage lymph node dissection may improve oncologic control in the treated region without improving the outfield relapse risk or the prostate specific antigen response. Great heterogeneity among series in adjuvant treatments, endpoints, progression definitions and study populations made it difficult to assess the precise impact of salvage treatment on the prostate specific antigen response and compare outcomes between radiotherapy and salvage lymph node dissection series. Toxicity after radiotherapy or salvage lymph node dissection was acceptable without frequent high grade complications. The benefit of early hormone therapy as the only salvage treatment remains unknown. Conclusions Although a high level of evidence is currently missing to draw any strong conclusion, published clinical series show that in select patients salvage treatment directed to nodal recurrence could lead to good oncologic outcomes. Although the optimal timing of androgen deprivation therapy in this setting is still unknown, such an approach could delay time to systemic treatment with an acceptable safety profile. Future prospective trials are awaited to better clarify this potential impact on well-defined endpoints.

Published
2015

37. Influence of statin use on clinicopathological characteristics of localized prostate cancer and outcomes obtained after radical prostatectomy: a single center study

Author

Susanna, Cattarino, Thomas, Seisen, Sarah J, Drouin, Raphaële, Renard-Penna, Priscilla, Leon, Eva, Comperat, Pierre, Mozer, Olivier, Cussenot, and Morgan, Rouprêt

Subjects
Aged, Biopsy, Follow-Up Studies, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Prognosis, Prostate, Prostate-Specific Antigen, Prostatectomy, Prostatic Neoplasms, Retrospective Studies, Treatment Outcome, Neoplasm Recurrence, Local
Abstract

To assess the impact of statin use on biochemical recurrence (BCR) of prostate cancer after radical prostatectomy (RP).Data from all men treated with robot-assisted laparoscopic RP (RALRP) for localized prostate cancer between 2009 and 2014 at our institution were prospectively collected: age, body mass index (BMI), statin-use status, preoperative prostate-specific antigen (PSA) level, clinical T stage, biopsy Gleason score (bGS), D'Amico risk group, pathological T stage, specimen Gleason score (sGS), multifocality, peri neural invasion, positive surgical margins and time to BCR. Univariate and multivariate analysis were performed to test associations between statin use and prognostic factors of prostate cancer and/or BCR.Overall, 591 patients with a median follow up of 42.3 months [25.8-59.9] were included in the current study and split in two cohorts: statin users (n = 156) and statin non-users (n = 435). When comparing statin user and non-users, no significant difference was found in terms of clinical, biochemical and pathological characteristics except for BMI (median 29 versus 26, respectively; p = 0.04). Regarding BCR, there was no significant difference between men using statin versus those not using them (4.5% versus 4.6%, p = 0.65). In univariate analysis, statin use was not significantly correlated to any prognostic factors of prostate cancer recurrence. Furthermore, there was no significant difference in the 5 years biochemical-free survival rates between statin users and non-users (75% versus 73%; p = 0.7).From the current study, statin daily intake was not significantly associated with any prognostic factors of prostate cancer and with BCR after RARLP.

Published
2015

38. Primary adrenal insufficiency due to bilateral adrenal hemorrhage-adrenal infarction in the antiphospholipid syndrome: long-term outcome of 16 patients

Author

Baptiste Hervier, Alexis Mathian, Christiane Coussieu, Philippe Grenier, Abdelhai Bennani, Bertrand Wechsler, Rafik Karmali, Zahir Amoura, Brigitte Velkeniers, Anne Bachelot, Denis Wahl, Raphaële Renard-Penna, Philippe Touraine, Du Boutin-Le Thi Huong, Julien Haroche, Nathalie Costedoat-Chalumeau, Isolde Ramon, Jean-Charles Piette, and Internal Medicine Specializations

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Adrenal Gland Diseases, Infarction, Context (language use), Hemorrhage, Biochemistry, Primary Adrenal Insufficiency, Endocrinology, Addison Disease, Antiphospholipid syndrome, Internal medicine, Adrenal Glands, medicine, Adrenal insufficiency, Humans, Child, Hydrocortisone, Retrospective Studies, business.industry, Biochemistry (medical), Middle Aged, medicine.disease, Antiphospholipid Syndrome, Addison's disease, Female, Adrenal Hemorrhage, business, medicine.drug
Abstract

Context: Primary adrenal insufficiency due to bilateral adrenal hemorrhage-adrenal infarction is a rare and life-threatening manifestation of the antiphospholipid syndrome (APLS). Data on the long-term outcome are scarce. Objective: The aims of the present study were to analyze the long-term outcome related to APLS per se and to characterize the course of adrenal involvement. Design: We conducted a retrospective study of patients with bilateral adrenal hemorrhage-adrenal infarction secondary to APLS seen in the Department of Internal Medicine of Pitié-Salpêtrière Hospital in Paris (France) between January 1990 and July 2010. Results: Three patients died during the acute phase related to APLS manifestations. Sixteen patients (7 males; 9 females) were followed up during a median period of 3.5 years (range 0.3–28.1 years). Three episodes of recurrent thrombosis were noted. One patient died from cerebral hemorrhage 3 months after the onset of adrenal insufficiency. Repeated Synacthen tests showed complete absence of response in 8 of the 10 patients assessed; cortisol and aldosterone increased appropriately in one patient and to some extent in another one. Dehydroepiandrosterone levels and 24-hour urinary epinephrine levels remained abnormally low in all evaluated patients. Adrenal imaging performed more than 1 year after the initial event revealed completely atrophic glands in 9 of 11 patients. Conclusions: This particular subset of APLS patients who survive the acute phase has a rather favorable long-term outcome. Although adrenal dysfunction is generally irreversible, adrenocortical function may, at least partially, recover in rare cases. In this view, measurement of early morning cortisol during follow-up is indicated to detect these patients.

Published
2013

39. Accuracy of high resolution (1.5 tesla) pelvic phased array magnetic resonance imaging (mri) in staging prostate cancer in candidates for radical prostatectomy: results from a prospective study

Author

Amine Ayed, Raphaële Renard-Penna, Morgan Rouprêt, Philippe Grenier, Evanguelos Xylinas, Pierre Mozer, Eva Comperat, Mathieu Coudert, Marc-Olivier Bitker, Institut Universitaire de Cancérologie [Paris] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire Ondes et Matière d'Aquitaine (LOMA), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Service d'Urologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut des Systèmes Intelligents et de Robotique (ISIR), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Assistance aux Gestes et Applications THErapeutiques (AGATHE), Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), Laboratoire d'imagerie fonctionnelle [Paris] (LIF), Université Pierre et Marie Curie - Paris 6 (UPMC), Institut Universitaire de Cancérologie [Sorbonne Université] (IUC), Laboratoire d'imagerie fonctionnelle [CHU Pitié-Salpétriêre] (LIF), and Université Pierre et Marie Curie - Paris 6 (UPMC)-CHU Pitié-Salpêtrière [AP-HP]

Subjects
Adult, Male, medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Urology, medicine.medical_treatment, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Pelvis, 030218 nuclear medicine & medical imaging, [SPI.AUTO]Engineering Sciences [physics]/Automatic, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, Image Processing, Computer-Assisted, medicine, Humans, Prospective Studies, Stage (cooking), Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Aged, Digital Rectal Examination, Neoplasm Staging, Prostatectomy, medicine.diagnostic_test, business.industry, Prostatic Neoplasms, Magnetic resonance imaging, Middle Aged, Prostate-Specific Antigen, Prognosis, medicine.disease, Neurovascular bundle, Magnetic Resonance Imaging, Prostate-specific antigen, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Radiology, business, Follow-Up Studies
Abstract

Objective To evaluate the role of pelvic phased array MRI in staging prostate cancer (CaP). Materials and methods We prospectively collected data over 12 months on CaP patients who underwent preoperative MR imaging with a pelvic phased array before radical prostatectomy. MR images were analyzed prospectively by 2 radiologists. MR imaging findings were then correlated with pathologic findings. Results Overall, 101 patients were included with a mean PSA level of 8 (range 1.8–30). Reader 1 (AUC 0.895, 95% CI 0.791–0.999) had a higher performance than reader 2 (AUC 0.687, 95% CI, 0.555–0.819) and than DRE (AUC 0.728, 95% CI, 0.599–0.857) in discriminating T2 from T3 CaP (P = 0.01). The κ-index of inter-observer agreement was 0.56. A model that combines MRI findings, DRE, PSA, and Gleason score was the most competitive for staging (AUC 0.895, 95% CI, 0.791–0.999). For the multivariate analysis, 3 criteria were significantly associated with extracapsular extension: asymmetry of the neuro-vascular bundles (P = 0.001), asymmetric enhancement of neurovascular bundles (P = 0.02), and bulging of the capsule (P = 0.0003). Conclusion Pelvic phased array MRI presented satisfying results in its ability to adequately stage CaP and notably in detecting the extracapsular extension of tumors. It is likely to provide reliable information but rather in the hands of an experienced radiologist.

Published
2011

40. Resultados funcionales de la pieloplastia laparoscópica pura y asistida por robot

Author

Christophe Vaessen, Morgan Rouprêt, François Richard, Raphaële Renard-Penna, V. Misraï, Emmanuel Chartier-Kastler, and Karim Ferhi

Subjects
Laparoscopia, business.industry, Urology, Pieloplastia, Medicine, Obstrucción de la unión pieloureteral, Robótica, business, Humanities
Abstract

Resumen El tratamiento del sindrome de la union pieloureteral (UPU) ha evolucionado considerablemente durante los ultimos 20 anos gracias a la aparicion de las nuevas tecnicas quirurgicas. Tradicionalmente, el tratamiento del sindrome de la UPU se basaba en la pieloplastia mediante cirugia abierta que, actualmente, continua siendo el tratamiento de referencia. Se han desarrollado, asimismo, alternativas quirurgicas entre las que se encuentra la endopielotomia, aunque con resultados inferiores. De esta forma, la via laparoscopica ha experimentado un auge en esta indicacion. La pieloplastia laparoscopica presenta indices de efectividad que suelen rozar el 95% y ofrece las ventajas de un postoperatorio mas llevadero y estancias hospitalarias mas cortas. No obstante, esta tecnica es de dificil acceso para la mayoria si se tiene en cuenta las dificultades tecnicas y las limitaciones que tiene el cirujano. La curva de aprendizaje puede llegar a ser, por lo tanto, desalentadora. Desde el ano 2000, la robotica se ha desarrollado de forma paralela, con resultados funcionales tan satisfactorios como los obtenidos en la laparoscopia pura. El robot es mas accesible para el cirujano, ya que resulta mas ergonomico y la tecnica de sutura parece mas reproducible. Sin embargo, el mayor obstaculo para la difusion de esta tecnica es su coste, aun elevado, especialmente en tratamientos de afecciones raras, como es el caso del sindrome de la UPU. Los indices de efectividad obtenidos con el robot son superiores al 95%, tanto radiologicos como clinicos.

Published
2009

41. Mapping of transrectal ultrasonographic prostate biopsies: quality control and learning curve assessment by image processing

Author

Pierre Conort, Emmanuel Chartier-Kastler, Alexandre Moreau-Gaudry, Michael Baumann, S. Bart, Eva Comperat, Pierre Mozer, Jocelyne Troccaz, Grégoire Chevreau, Marc-Olivier Bitker, Raphaële Renard-Penna, François Richard, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), INtegrative research unit on Social and Individual DEvelopment (INSIDE), University of Luxembourg [Luxembourg], Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Centre d'Investigation Clinique [Grenoble] (CIC Grenoble), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Institut National de la Santé et de la Recherche Médicale (INSERM), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), PHRC National Prostate-Echo, and ANR-05-RNTS-0010,SMI,Surgétique Minimalement Invasive(2005)

Subjects
Male, FOS: Computer and information sciences, medicine.medical_specialty, Quality Assurance, Health Care, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Other Computer Science (cs.OH), [INFO.INFO-OH]Computer Science [cs]/Other [cs.OH], FOS: Physical sciences, Image processing, Sensitivity and Specificity, Prostate cancer, Professional Competence, Prostate, Computer Science - Other Computer Science, Image Interpretation, Computer-Assisted, Biopsy, medicine, Humans, Radiology, Nuclear Medicine and imaging, Local anesthesia, Ultrasonography, Interventional, Observer Variation, Median score, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Biopsy, Needle, Rectum, Reproducibility of Results, Professional competence, Image Enhancement, medicine.disease, Physics - Medical Physics, medicine.anatomical_structure, [PHYS.PHYS.PHYS-MED-PH]Physics [physics]/Physics [physics]/Medical Physics [physics.med-ph], France, Radiology, Medical Physics (physics.med-ph), business, Quality assurance
Abstract

International audience; OBJECTIVE: Mapping of transrectal ultrasonographic (TRUS) prostate biopsies is of fundamental importance for either diagnostic purposes or the management and treatment of prostate cancer, but the localization of the cores seems inaccurate. Our objective was to evaluate the capacities of an operator to plan transrectal prostate biopsies under 2-dimensional TRUS guidance using a registration algorithm to represent the localization of biopsies in a reference 3-dimensional ultrasonographic volume. METHODS: Thirty-two patients underwent a series of 12 prostate biopsies under local anesthesia performed by 1 operator using a TRUS probe combined with specific third-party software to verify that the biopsies were indeed conducted within the planned targets. RESULTS: The operator reached 71% of the planned targets with substantial variability that depended on their localization (100% success rate for targets in the middle and right parasagittal parts versus 53% for targets in the left lateral base). Feedback from this system after each series of biopsies enabled the operator to significantly improve his dexterity over the course of time (first 16 patients: median score, 7 of 10 and cumulated median biopsy length in targets of 90 mm; last 16 patients, median score, 9 of 10 and a cumulated median length of 121 mm; P = .046). CONCLUSIONS: In addition to being a useful tool to improve the distribution of prostate biopsies, the potential of this system is above all the preparation of a detailed "map" of each patient showing biopsy zones without substantial changes in routine clinical practices.

Published
2009
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42. Visualizing BK virus nephropathy

Author

Lucile Mercadal, Raphaële Renard Penna, Benoit Barrou, Jérôme Tourret, and Isabelle Brocheriou

Subjects
Transplantation, medicine.medical_specialty, Creatinine, Kidney, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Urology, Renal function, Immunosuppression, medicine.disease, medicine.disease_cause, Nephropathy, BK virus, chemistry.chemical_compound, medicine.anatomical_structure, chemistry, Nephrology, Biopsy, medicine, business, Kidney transplantation
Abstract

A 55-year-old man received a kidney transplantation in June 2008 (diabetic end-stage renal disease). Induction of immunosuppression consisted of basiliximab, methylprednisolone and mycophenolate mofetil. Maintenance therapy consisted of prednisone, mycophenolate mofetil and tacrolimus. In December 2008, a kidney biopsy was performed because of deteriorated kidney function and blood BK virus (BKV) replication (105.9 copies/mL). The biopsy showed prominent lymphocytic interstitial infiltrates. Tubulitis was inconspicuous (Figure 1A). Intranuclear inclusion bodies with ground-glass appearance and peripheral chromatin rimming could be seen in some tubular epithelial cells consistent with BKV infection (Figure 1B). No deposits were identified by immunofluorescence. Immunosuppression was reduced. Ten days after the biopsy, a contrast-enhanced CT scan was performed for intercurrent intestinal discomfort (no specific diagnosis made, with spontaneous recovery). The CT scan showed multiple wedge-shaped areas and streaky zones of lesser enhancement that extended from the papilla to the renal cortex (Figure 2). Ultrasonography performed the same day showed very similar abnormalities. The patient was afebrile. The urine dipstick showed no leucocytes, no red blood cells and no nitrite. The C-reactive protein was 5.5 mg/dL (N

Published
2009

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