Prostate biopsies

PSA determination can be used to investigate the necessity for a prostate biopsy. PSA is considered a useful analyte in the diagnosis and management of prostate cancer however, increased serum concentrations of PSA are also seen in patients without cancer of the prostate (e.g., patients with bacterial prostatitis or benign... 

Slater MD, Murphy CR. Co-expression of interleukin-6 and human growth hormone in apparently normal prostate biopsies that ultimately progress to prostate cancer using low pH, high temperature antigen retrieval. /. Mol. Histol. 2006 37 37-41. 

Transrectal prostate biopsy A single 400 mg dose 1 to 6 hours prior to the procedure. 

King, C. R., and Long, J. P. 2000. Prostate biopsy grading errors a sampling problem hit. J. Cancer 90 326-330. 

A 71-year-old man received intrathecal anesthesia using 0.3% cinchocaine 2 ml for a transurethral prostatectomy (8). He had a history of allergic rhinitis, and 2 months before had had an uneventful prostate biopsy and cystoscopy, also under spinal anesthesia with iso-baric bupivacaine. Within 45 minutes of the spinal injection he complained of periorbital itching, started to shake, and developed muscle rigidity. He rapidly became unconscious, with a systolic blood pressure of 40 mmHg and widespread erythema. He was treated with hydrocortisone and antihistamines and required an infusion of adrenaline. Intradermal testing after full recovery was positive with cinchocaine. 

Single point spectra of prostate biopsy specimen... 

The first study where the SCS was applied to MRS analysis of prostate biopsies was undertaken at the IBD in Winnipeg.42 Proton MRS (Bruker Instruments, 8.5 T were performed at 37°C on specimens of benign (n = 66) and malignant (n = 21) human prostate tissue specimens collected from transurethral resection of the prostate and radical prostatectomy from 50 patients. Typical spectra of malignant prostate tissue and benign prostate hyperplasia (BPH) are shown in Fig. 5.42 The spectral data were subjected to visual inspection analysis and multivariate analysis, specifically LDA. 

Fig. 5. Prostate biopsy. H MR spectra (8.5 T, 37°C), of human prostate biopsy specimens (a) cancer (Gleason s grade 3+3) (b) benign prostatic hyperplasia (BPH). MR spectra were collected with presaturation of the water signal. Acquisition parameters included number of scans, 256 or 640, sweep width 5000 Hz, delay 2.41 s, and time domain data points 4K. Reprinted from Cancer Research with permission from the American Association for Cancer Research.

R. L. Somorjai, R. Bourne, A. E. Nikulin, B. Dolenko, P. Russell and C. E. Mountford, Classification and regression analyses of known mixtures of cancer and benign tissue in prostate biopsies, Proceedings in International Society of Magnetic Resonance in Medicine, 2002. 

Remzi M, Anagnostou T, Ravery V, et al. An artificial neural network to predict the outcome of repeat prostate biopsies. Urology 2003 62 456-60. 

Nishiyama et al. (2004) set out to quantitate DHT in human serum and prostate biopsy tissue using LC-MS with charged derivatization to the A-methylpyridinium derivative. Prostate tissue DHT was dissolved in alkaline solution, extracted by SPE and derivatized before LC-MS analysis [ESI, positive ion mode, selected reaction monitoring (SRM)]. Pretreatment values in patients with N = 69) or without N = 34) prostate cancer were, for serum DHT, 423.9 pg mL ( 1.46 nmol L ) with SD 243.2 pg mL (< 0.84 nmol L ) or... 

Many other tests can be performed if additional information is needed to assess the severity of BPH disease and its complications, or assist in the preoperative assessment of the patient, including a voiding cystometrogram, transrectal ultrasound of the prostate, intravenous pyelogram, renal ultrasound, and prostate biopsy. 

Transperianal or transrectal prostate biopsy is necessary to confirm a prostate cancer diagnosis and to grade the tumor specimen. TRUS-guided biopsies of hypoechoic areas may help define extraprostatic extension. For patients with visceral or lytic metastases, these lesions may be biopsied, because this presentation is common for one... 

D.K. Ornstein, J. Kang, How to improve prostate biopsy detection of prostate cancer, Gurr. Urology Rep. 2 (2001) 218. 

In prostate biopsies, immunomarkers that can assist reaching a diagnosis of carcinoma in a small focus of atypical glands are of great utility. The latter has been especially valuable in an organ such as the prostate where a repeat biopsy does not always reach the target focus for additional sampling. The layer of assurance rendered by multiple immunostains used in prostate... 

Here we focus our discussion on four lesions that pose a unique differential challenge when encountered in a prostatic biopsy. 

Martens MB, Keller JH. Routine immunohistochemical staining for high-molecular weight cytokeratin 34-beta and alpha-methylacyl CoA racemase (P504S) in postirradiation prostate biopsies. Mod Pathol. 2006 19 287. 

Crook JM, Bahadur YA, Robertson SJ, et al. Evaluation of radiation effect, tumor differentiation, and prostate specific antigen staining in sequential prostate biopsies after external beam radiotherapy for patients with prostate carcinoma. Cancer. 1997 79 81. 

In men with positive prostate biopsies, oral administration of a standardized green tea extract containing 1.3 g green tea polyphenols (800 mg EGCG) daily for 12 to 214 days (mean of 34 days) was studied a decrease in liver enzyme levels, including aspartate aminotransferase, alkaline phosphatase, and amylase, was observed (McLarty et al. 2009). 

Table 4 MR-compatible prostate biopsy robot systems...

Song, S.E., Cho, N.B., Fischer, G., Hata, N., Tempany, C., Fichtinger, G., lordachita, L Development of a pneumatic robot for MRI-guided transperineal prostate biopsy and brachytherapy New approaches. In IEEE International Conference on Robotics and Automation, pp. 2580-2585 (2010)... 

Yakar, D., Schouten, M.G., Bosboom, D.G.H., Barentsz, J.O., Scheenen, T.W.J., Futterer, J.J. Feasibility of a pneumatically actuated MR-compatible robot for trans-rectal prostate biopsy guidance. Radiology 260(1), 241-247 (2011)... 

Fig. 28.4. Close view of the robot for transurethral prostate biopsy. The principal components and motion stages (with indication to their degrees of freedom, or DOF) are labeled individually [Reproduced from Fichtinger et al. (2006) with permission]...

Fichtinger G, DeWeese TL, Patriciu A et al (2002) System for robotically assisted prostate biopsy and therapy with intraoperative CT guidance. Acad Radiol 9 60-74 Geis WP, Kim HC, Brennan EJ Jr, McAfee PC, Wang Y (1996) Robotic arm enhancement to accommodate improved efficiency and decreased resource utilization in complex minimally invasive surgical procedures. Stud Health Technol Inform 29 471-481... 

Susil RC, Menard C, Krieger A et al (2006) Transrectal prostate biopsy and fiducial marker placement in a standard 1.5 T magnetic resonance imaging scanner. J Urol 175 113-120... 

Often it is possible to provide clinicians with additional or enhanced image information not inherently present intraoperatively. Modahties such as CT and MRI are not typically available in the operating room, but are often the optimal source for clearly identifying target tissues. In such situations, the best approach is to register the preoperative image data with the intraoperative modalities, as for example during prostate biopsies [20]. 

Stephenson SK, Chang EK, Marks LS. Screening and detection advances in magnetic resonance image-guided prostate biopsy. Urol Chn North Am 2014 41(2) 315—26. 

Figure 22.3 Ultrasound image (left) and MR image (right) of same prostate (Reproduced with permission from Real time MRI-ultrasound image guided stereotactic prostate biopsy by Kaplan, I., Oldenburg, N.E., Meskell, P., et al. Magnetic Resonance Imaging, 20, 3. Copyright (2002) Elsevier).

Yuen, J.S.P., Thng, C.H., Tan, P.H., et al. (2004) Endorectal Magnetic Resonance Imaging and Spectroscopy for the Detection of Tumor Foci in Men with Prior Negative Transrectal Ultrasound Prostate Biopsy, J. Urology, 171, 1482-68. 

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