Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure

Objective: To assess the impact of iterative changes in preoperative and postoperative biopsy techniques on the outcomes of men undergoing the precision prostatectomy procedure. Precision prostatectomy is a novel surgical treatment for prostate cancer that aims to maximally preserve erectogenic nerves via partial preservation of the prostate capsule. Design: Retrospective. Setting: Single tertiary care center. Participants: This study included 120 patients who consented to undergo prostate cancer treatment with the precision prostatectomy procedure. Patients were originally enrolled in one of two separate prospective protocols studying precision prostatectomy. Interventions: Preoperatively, 60 patients were screened with transrectal (TR) biopsy and 60 were screened by transperineal (TP) biopsy. Ultimately, 117 patients underwent precision prostatectomy. Of the 43 postoperative biopsies, 19 were TR; 17 were TP with ultrasound; and 7 were TP with microultrasound (mUS). Main outcome measures: Preoperatively, we evaluated whether the transition to TP biopsy was associated with differences in postoperative treatment failure defined as a neoplasm-positive postoperative biopsy. Postoperative biopsies were compared with respect to their ability to sample the remnant tissue, specifically percentage of cores positive for prostate tissue. Results: Preoperatively, 9/60 (15%) positive postoperative biopsies occurred in the TR group and 6/60 (10%) in the TP group; Kaplan-Meier survival estimates did not differ between groups (p=0.69 by log rank). Postoperatively, the numbers of cores positive for prostate tissue were 99/160 (62%), 63/107 (59%), and 36/39 (92%) in the TR biopsy, TP with ultrasound, and TP with mUS groups, respectively; this difference was statistically significant versus the rate in the TR and standard TP groups (p=0.0003 and 0.0002). Conclusion: We found no significant improvement in patient screening, preoperatively-though limited by small sample size and relatively short follow-up. The incorporation of high-frequency mUS for postoperative biopsies improved the ability to sample the remnant tissue with a higher efficiency

Eine service-orientierte Grid-Infrastruktur zur Unterstützung medienwissenschaftlicher Filmanalyse

Innerhalb des von der DFG (SFB/FK 615) geförderten Projektes „Methoden und Werkzeuge zur rechnergestützten medienwissenschaftlichen Analyse“ werden Verfahren und Werkzeuge entwickelt, die Medienwissenschaftler bei der Analyse von audiovisuellen Daten unterstützen sollen. In diesem Beitrag wird die Videoanalyse-Software Videana vorgestellt, die eigens entwickelte Verfahren und Konzepte zur Analyse von audio-visuellen Daten beinhaltet. Weiterhin werden Forschungsarbeiten bezüglich einer Grid-Infrastruktur zur Unterstützung medienwissenschaftlicher Forschungsarbeiten sowie zur service-orientierten Analyse von Multimediadaten präsentiert. So verfügt Videana beispielsweise über eine integrierte Grid-Anbindung und erlaubt Mitgliedern einer virtuellen Organisation, rechenintensive Analyseaufgaben auf externen Rechenressourcen auszuführen

The Mount Sinai Prebiopsy Risk Calculator for Predicting any Prostate Cancer and Clinically Significant Prostate Cancer: Development of a Risk Predictive Tool and Validation with Advanced Neural Networking, Prostate Magnetic Resonance Imaging Outcome Database, and European Randomized Study of Screening for Prostate Cancer Risk Calculator

Background: The European Association of Urology guidelines recommend the use of imaging, biomarkers, and risk calculators in men at risk of prostate cancer. Risk predictive calculators that combine multiparametric magnetic resonance imaging with prebiopsy variables aid as an individualized decision-making tool for patients at risk of prostate cancer, and advanced neural networking increases reliability of these tools.Objective: To develop a comprehensive risk predictive online web-based tool using magnetic resonance imaging (MRI) and clinical data, to predict the risk of any prostate cancer (PCa) and clinically significant PCa (csPCa) applicable to biopsy-naive men, men with a prior negative biopsy, men with prior positive low-grade cancer, and men with negative MRI.Design, setting, and participants: Institutional review board-approved prospective data of 1902 men undergoing biopsy from October 2013 to September 2021 at Mount Sinai were collected.Outcome measurements and statistical analysis: Univariable and multivariable analyses were used to evaluate clinical variables such as age, race, digital rectal examination, family history, prostate-specific antigen (PSA), biopsy status, Prostate Imaging Reporting and Data System score, and prostate volume, which emerged as predictors for any PCa and csPCa. Binary logistic regression was performed to study the probability. Validation was performed with advanced neural networking (ANN), multi-institutional European cohort (Prostate MRI Outcome Database [PROMOD]), and European Randomized Study of Screening for Prostate Cancer Risk Calculator (ERSPC RC) 3/4.Results and limitations: Overall, 2363 biopsies had complete clinical information, with 57.98% any cancer and 31.40% csPCa. The prediction model was significantly associated with both any PCa and csPCa having an area under the curve (AUC) of 81.9% including clinical data. The AUC for external validation was calculated in PROMOD, ERSPC RC, and ANN for any PCa (0.82 vs 0.70 vs 0.90) and csPCa (0.82 vs 0.78 vs 0.92), respectively. This study is limited by its retrospective design and over-estimation of csPCa in the PROMOD cohort.Conclusions: The Mount Sinai Prebiopsy Risk Calculator combines PSA, imaging and clinical data to predict the risk of any PCa and csPCa for all patient settings. With accurate validation results in a large European cohort, ERSPC RC, and ANN, it exhibits its efficiency and applicability in a more generalized population. This calculator is available online in the form of a free web-based tool that can aid clinicians in better patients counseling and treatment decision-making.Patient summary: We developed the Mount Sinai Prebiopsy Risk Calculator (MSP-RC) to assess the likelihood of any prostate cancer and clinically significant disease based on a combination of clinical and imaging characteristics. MSP-RC is applicable to all patient settings and accessible online. Crown Copyright (C) 2022 Published by Elsevier B.V. on behalf of European Association of Urology.</p

Eine service-orientierte Grid-Infrastruktur zur Unterstützung medienwissenschaftlicher Filmanalyse

Innerhalb des von der DFG (SFB/FK 615) geförderten Projektes „Methoden und Werkzeuge zur rechnergestützten medienwissenschaftlichen Analyse“ werden Verfahren und Werkzeuge entwickelt, die Medienwissenschaftler bei der Analyse von audiovisuellen Daten unterstützen sollen. In diesem Beitrag wird die Videoanalyse-Software Videana vorgestellt, die eigens entwickelte Verfahren und Konzepte zur Analyse von audio-visuellen Daten beinhaltet. Weiterhin werden Forschungsarbeiten bezüglich einer Grid-Infrastruktur zur Unterstützung medienwissenschaftlicher Forschungsarbeiten sowie zur service-orientierten Analyse von Multimediadaten präsentiert. So verfügt Videana beispielsweise über eine integrierte Grid-Anbindung und erlaubt Mitgliedern einer virtuellen Organisation, rechenintensive Analyseaufgaben auf externen Rechenressourcen auszuführen

Eine service-orientierte Grid-Infrastruktur zur Unterstützung medienwissenschaftlicher Filmanalyse

Innerhalb des von der DFG (SFB/FK 615) geförderten Projektes „Methoden und Werkzeuge zur rechnergestützten medienwissenschaftlichen Analyse“ werden Verfahren und Werkzeuge entwickelt, die Medienwissenschaftler bei der Analyse von audiovisuellen Daten unterstützen sollen. In diesem Beitrag wird die Videoanalyse-Software Videana vorgestellt, die eigens entwickelte Verfahren und Konzepte zur Analyse von audio-visuellen Daten beinhaltet. Weiterhin werden Forschungsarbeiten bezüglich einer Grid-Infrastruktur zur Unterstützung medienwissenschaftlicher Forschungsarbeiten sowie zur service-orientierten Analyse von Multimediadaten präsentiert. So verfügt Videana beispielsweise über eine integrierte Grid-Anbindung und erlaubt Mitgliedern einer virtuellen Organisation, rechenintensive Analyseaufgaben auf externen Rechenressourcen auszuführen

Evaluating post radical prostatectomy mechanisms of early continence

BACKGROUND: To identify the periprostatic structures associated with early return of urinary continence after radical prostatectomy (RP). METHODS: We compared total continence results between four different techniques of robot-assisted radical prostatectomy (RARP). Specifically, we studied 1-week and 1-month zero-pad continence rates of anterior (n = 60), posterior (n = 59), a novel hybrid posterior-anterior (n = 12), and transvesical (n = 12) approaches of RARP. Each technique preserved a unique set of periprostatic anatomic structures, thereby, allowing evaluation of the individual impact of preservation of nerves, bladder neck, and space of Retzius with associated anterior support structures on early continence. Urethral length was preserved in all approaches. The space of Retzius was preserved in posterior and transvesical approaches, while the bladder neck was preserved in posterior and hybrid approaches. Nerve sparing was done per preoperative oncological risk. For all patients, 24-h pad usage rates and 24-h pad weights were noted at 1 week and 1 month after catheter removal. Multivariable logistic regression analysis was performed to identify predictors of early continence. Data were obtained from prospective studies conducted between 2015 and 2021. RESULTS: At 1 week, 15%, 42%, 45%, and 8% of patients undergoing anterior, posterior, hybrid, and transvesical RARP approaches, respectively, were totally continent (p = 0.003). These rates at 1 month were 35%, 66%, 64%, and 25% (p = 0.002), respectively. The transvesical approach, which preserved the space of Retzius but not the bladder neck, was associated with the poorest continence rates, while the posterior and hybrid approaches in which the bladder neck was preserved with or without space of Retzius preservation were associated with quickest urinary continence recovery. Bladder neck preservation was the only significant predictor of 1-week and 1-month total continence recovery in adjusted analysis, Odds ratios 9.06 (p = 0.001) and 5.18 (p = 0.004), respectively. CONCLUSIONS: The beneficial effect of the Retzius-sparing approach on early continence recovery maybe associated with bladder neck preservation rather than space of Retzius preservation