Detection of Significant Prostate Cancer Using Target Saturation in Transperineal Magnetic Resonance Imaging/Transrectal Ultrasonography-fusion Biopsy

BACKGROUND: Multiparametric magnetic resonance imaging (mpMRI) and targeted biopsies (TBs) facilitate accurate detection of significant prostate cancer (sPC). However, it remains unclear how many cores should be applied per target. OBJECTIVE: To assess sPC detection rates of two different target-dependent magnetic resonance imaging (MRI)/transrectal ultrasonography (TRUS)-fusion biopsy approaches (TB and target saturation [TS]) compared with extended systematic biopsies (SBs). DESIGN, SETTING, AND PARTICIPANTS: Retrospective single-centre outcome of transperineal MRI/TRUS-fusion biopsies of 213 men was evaluated. All men underwent TB with a median of four cores per MRI lesion, followed by a median of 24 SBs, performed by experienced urologists. Cancer and sPC (International Society of Urological Pathology grade group ≥2) detection rates were analysed. TB was compared with SB and TS, with nine cores per target, calculated by the Ginsburg scheme and using individual cores of the lesion and its "penumbra". OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Cancer detection rates were calculated for TS, TB, and SB at both lesion and patient level. Combination of SB + TB served as a reference. Statistical differences in prostate cancer (PC) detection between groups were calculated using McNemar's tests with confidence intervals. RESULTS AND LIMITATIONS: TS detected 99% of 134 sPC lesions, which was significantly higher than the detection by TB (87%, p = 0.001) and SB (82%, p < 0.001). SB detected significantly more of the 72 low-risk PC lesions than TB (99% vs 68%, p < 0.001) and 10% (p = 0.15) more than that detected by TS. At a per-patient level, 99% of men harbouring sPC were detected by TS. This was significantly higher than that by TB and SB (89%, p = 0.03 and 81%, p = 0.001, respectively). Limitations include limited generalisability, as a transperineal biopsy route was used. CONCLUSIONS: TS detected significantly more cases of sPC than TB and extended SB. Given that both 99% of sPC lesions and men harbouring sPC were identified by TS, the results suggest that this approach allows to omit SB cores without compromising sPC detection. PATIENT SUMMARY: Target saturation of magnetic resonance imaging-suspicious prostate lesions provides excellent cancer detection and finds fewer low-risk tumours than the current gold standard combination of targeted and systematic biopsies

Ongoing studies for the control system of a serially powered ATLAS pixel detector at the HL-LHC

In terms of the phase-2 upgrade of the ATLAS detector, the entire inner tracker (ITk) of ATLAS will be replaced. This includes the pixel detector and the corresponding detector control system (DCS). The current baseline is a serial powering scheme of the detector modules. Therefore a new detector control system is being developed with emphasis on the supervision of serially powered modules. Previous chips had been designed to test the radiation hardness of the technology and the implementation of the modified I2C as well as the implementation of the logic of the CAN protocol. This included tests with triple redundant registers. The described chip is focusing on the implementation in a serial powering scheme. It was designed for laboratory tests, aiming for the proof of principle. The concept of the DCS for ATLAS pixel after the phase-2 upgrade is presented as well as the status of development including tests with the prototype ASIC

Die Fusionsbiopsie in der Primärdiagnostik des Prostatakarzinoms

Prostate carcinoma is one of the most common tumors worldwide. Histological confirmation by biopsy is an obligatory part of the diagnostic approach. The main problem of the 10–12-fold transrectal ultrasound-guided (TRUS) biopsy, which has so far been regarded as the gold standard, is the underdiagnosis of clinically significant cancer. MRI-based procedures, so-called fusion biopsies, have shown superior results when compared to conventional biopsies. There are three different approaches (cognitive and software-based MRI/TRUS fusion and in-bore biopsy) with comparable detection rates but differences in the technical aspects and time involvement. In order to reduce fusion errors, targeted biopsies should consist of multiple cores. There is currently no clear preference for the access pathway (transrectal or transperineal), but clinical parameters such as infection risk or location of the tumor can influence the decision. While the German S3 guideline considers MRI prior to primary biopsy to be optional, the 2019 European Association of Urology guidelines already recommend MRI prior to biopsy for all patients. The combination of MRI-targeted and systematic biopsy offers the highest detection rates with the disadvantage that more low-risk tumors are diagnosed. Both the patient and the urologist benefit from an improved informative value of the biopsy when deciding on active surveillance as well as when planning invasive therapies

Prototypes for components of a control system for the ATLAS pixel detector at the HL-LHC

In the years around 2020 an upgrade of the LHC to the HL-LHC is scheduled, which will increase the accelerators luminosity by a factor of 10. In the context of this upgrade, the inner detector of the ATLAS experiment will be replaced entirely including the pixel detector. This new pixel detector requires a specific control system which complies with the strict requirements in terms of radiation hardness, material budget and space for the electronics in the ATLAS experiment. The University ofWuppertal is developing a concept for a DCS (Detector Control System) network consisting of two kinds of ASICs. The first ASIC is the DCS Chip which is located on the pixel detector, very close to the interaction point. The second ASIC is the DCS Controller which is controlling 4x4 DCS Chips from the outer regions of ATLAS via differential data lines. Both ASICs are manufactured in 130 nm deep sub micron technology. We present results from measurements from new prototypes of components for the DCS network

Radiationhard components for the control system of a future ATLAS pixel detector

The upgrade of the ATLAS experiment for the High Luminosity LHC (HL-LHC) will include a new pixel detector. A completely new detector control system (DCS) for this pixel detector will be required in order to cope with the substantial increase in radiation at the HL-LHC. The DCS has to have a very high reliability and all components installed within the detector volume have to be radiationhard. This will ensure a safe operation of the pixel detector and the experiment. A further design constraint is the minimization of the used material and cables in order to limit the impact on the tracking performance to a minimum. To meet these requirements we propose a DCS network which consists of a DCS chip and a DCS controller. In the following we present the development of the first prototypes for the DCS chip and the DCS controller with a special focus on the communication interface, radiation hardness and robustness against single event upsets

Studies for the detector control system of the ATLAS pixel at the HL-LHC

In the context of the LHC upgrade to the HL-LHC the inner detector of the ATLAS experiment will be replaced completely. As part of this redesign there will also be a new pixel detector. This new pixel detector requires a control system which meets the strict space requirements for electronics in the ATLAS experiment. To accomplish this goal we propose a DCS (Detector Control System) network with the smallest form factor currently available. This network consists of a DCS chip located in close proximity to the interaction point and a DCS controller located in the outer regions of the ATLAS detector. These two types of chips form a star shaped network with several DCS chips being controlled by one DCS controller. Both chips are manufactured in deep sub-micron technology. We present prototypes with emphasis on studies concerning single event upsets