JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
Modernizing the Diagnostic and Decision-making Pathway for Prostate Cancer.
Clin. Cancer Res.
PUBLISHED: 10-16-2014
Show Abstract
Hide Abstract
PSA has lead to a drastic increase in the detection of prostate cancer, rendering this biomarker the gateway for the diagnostic pathway of prostatic neoplasms. However, the increase in incidence has not been mirrored by a similar reduction in mortality. Widespread PSA testing has facilitated over-diagnosis and over-treatment of indolent disease. To reduce this phenomenon and avoid negative repercussions on the quality-of-life of men undergoing unnecessary therapies, the diagnostic pathway of prostate cancer needs to be improved. Multi-parametric MRI (mp-MRI) can enhance sensitivity and specificity of PSA as well as the shortcomings of random biopsy sampling. This novel imaging technique has been proven to identify larger and more aggressive cancer foci, which should be targeted for treatment. New technological developments now allow for fusion of mp-MRI images with real-time ultrasound, opening the way to lesion-targeted biopsies. Furthermore, mp-MRI and targeted biopsies can also improve active surveillance protocols and permit more conservative focal therapy strategies. By implementing targeted biopsies, the diagnostic pathway will focus on clinically significant disease, consequently reducing over-diagnosis and over-treatment. Before this novel protocol becomes the new gold-standard, mp-MRI acquisition and interpretation need to be standardized and targeted-biopsy strategies need to be further validated prior to abandoning random-sampling ones. Several multi-disciplinary consortiums are already working on standardization of prostate MRI and there are ongoing prospective trials on targeted biopsies and MRI. Soon imaging of prostatic lesions and selected biopsies will modify the diagnostic evaluation of prostate cancer, reducing over-treatment and therapy-derived complications that negatively affect quality of life.
Related JoVE Video
B-Mode and Acoustic Radiation Force Impulse (ARFI) Imaging of Prostate Zonal Anatomy: Comparison with 3T T2-Weighted MR Imaging.
Ultrason Imaging
PUBLISHED: 07-26-2014
Show Abstract
Hide Abstract
Prostate cancer (PCa) is the most common non-cutaneous malignancy among men in the United States and the second leading cause of cancer-related death. Multi-parametric magnetic resonance imaging (mpMRI) has gained recent popularity to characterize PCa. Acoustic Radiation Force Impulse (ARFI) imaging has the potential to aid PCa diagnosis and management by using tissue stiffness to evaluate prostate zonal anatomy and lesions. MR and B-mode/ARFI in vivo imaging datasets were compared with one another and with gross pathology measurements made immediately after radical prostatectomy. Images were manually segmented in 3D Slicer to delineate the central gland (CG) and prostate capsule, and 3D models were rendered to evaluate zonal anatomy dimensions and volumes. Both imaging modalities showed good correlation between estimated organ volume and gross pathologic weights. Ultrasound and MR total prostate volumes were well correlated (R (2) = 0.77), but B-mode images yielded prostate volumes that were larger (16.82% ± 22.45%) than MR images, due to overestimation of the lateral dimension (18.4% ± 13.9%), with less significant differences in the other dimensions (7.4% ± 17.6%, anterior-to-posterior, and -10.8% ± 13.9%, apex-to-base). ARFI and MR CG volumes were also well correlated (R (2) = 0.85). CG volume differences were attributed to ARFI underestimation of the apex-to-base axis (-28.8% ± 9.4%) and ARFI overestimation of the lateral dimension (21.5% ± 14.3%). B-mode/ARFI imaging yielded prostate volumes and dimensions that were well correlated with MR T2-weighted image (T2WI) estimates, with biases in the lateral dimension due to poor contrast caused by extraprostatic fat. B-mode combined with ARFI imaging is a promising low-cost, portable, real-time modality that can complement mpMRI for PCa diagnosis, treatment planning, and management.
Related JoVE Video
Detection of prostate cancer with multiparametric MRI (mpMRI): effect of dedicated reader education on accuracy and confidence of index and anterior cancer diagnosis.
Abdom Imaging
PUBLISHED: 07-19-2014
Show Abstract
Hide Abstract
To evaluate the impact of dedicated reader education on accuracy/confidence of peripheral zone index cancer and anterior prostate cancer (PCa) diagnosis with mpMRI; secondary aim was to assess the ability of readers to differentiate low-grade cancer (Gleason 6 or below) from high-grade cancer (Gleason 7+).
Related JoVE Video
Psychosocial trajectories of men monitoring prostate-specific antigen levels following surgery for prostate cancer.
Oncol Nurs Forum
PUBLISHED: 06-28-2014
Show Abstract
Hide Abstract
To describe the psychosocial trajectories of men treated surgically for prostate cancer after monitoring their prostate-specific antigen (PSA) levels until 24 months post-treatment.
Related JoVE Video
Does the multidisciplinary approach improve oncological outcomes in men undergoing surgical treatment for prostate cancer?
Int. J. Urol.
PUBLISHED: 06-15-2014
Show Abstract
Hide Abstract
To determine whether oncological outcomes are improved in prostate cancer patients by using a multidisciplinary strategy as compared with a standard clinic paradigm, and whether time to treatment is delayed when using a multidisciplinary approach.
Related JoVE Video
Survival of patients undergoing cytoreductive surgery for metastatic renal cell carcinoma in the targeted-therapy era.
Anticancer Res.
PUBLISHED: 04-30-2014
Show Abstract
Hide Abstract
In the cytokine era, cytoreductive nephrectomy (CN) improves survival for patients with metastatic renal cell carcinoma (mRCC). We analyzed the effect of CN on the survival of patients diagnosed with mRCC in the era of tyrosine kinase inhibitors (2005-present).
Related JoVE Video
Comparing 3-T multiparametric MRI and the Partin tables to predict organ-confined prostate cancer after radical prostatectomy.
Urol. Oncol.
PUBLISHED: 03-21-2014
Show Abstract
Hide Abstract
The purpose of our study was to test our hypothesis that multiparametric magnetic resonance imaging (mpMRI) may have a higher prognostic accuracy than the Partin tables in predicting organ-confined (OC) prostate cancer and extracapsular extension (ECE) after radical prostatectomy (RP).
Related JoVE Video
How to select the right patients for focal therapy of prostate cancer?
Curr Opin Urol
PUBLISHED: 03-15-2014
Show Abstract
Hide Abstract
Just as lumpectomy for breast cancer aims at achieving oncological control with maximal tissue preservation, the concept of focal therapy for prostate cancer has evolved with the aim of controlling disease while preserving urinary and erectile function. Our review aims at describing the evolution of focal therapy in time and the resulting advances in patient selection.
Related JoVE Video
Metastatic ampullary adenocarcinoma presenting as a hydrocele: a case report.
JOP
PUBLISHED: 03-06-2014
Show Abstract
Hide Abstract
Metastases from ampullary malignancies are common, but spread to the testicle and paratesticular tissue is exceedingly rare with only 2 reported cases in the literature.
Related JoVE Video
Clinicopathological characteristics and outcomes of surgically excised renal masses in African Americans.
Urol. Oncol.
PUBLISHED: 02-02-2014
Show Abstract
Hide Abstract
In the present study, we report on the clinical and pathological characteristics of African American (AA) patients with surgically excised renal masses and assess the associations between race and oncological outcomes.
Related JoVE Video
Radiation exposure associated with dedicated renal mass computed tomography protocol: impact of patient characteristics.
J. Endourol.
PUBLISHED: 08-09-2013
Show Abstract
Hide Abstract
Renal mass protocol CT (RMP-CT) using multiphase abdomen and pelvis CT imaging is the mainstay for diagnosis, characterization, and follow-up for renal masses; however, it is associated with ionizing radiation to the patient. We sought to quantify the effective dose associated with RMP-CT and to determine how patient factors affect radiation exposure.
Related JoVE Video
Bilateral focal ablation of prostate tissue using low-energy direct current (LEDC): a preclinical canine study.
BJU Int.
PUBLISHED: 07-25-2013
Show Abstract
Hide Abstract
To evaluate side-effects, erectile function and capability to preserve adjacent tissues of bilateral focal prostate ablation using low-energy direct current (LEDC) in a canine model.
Related JoVE Video
Characteristics of patients diagnosed with both melanoma and renal cell cancer.
Cancer Causes Control
PUBLISHED: 07-20-2013
Show Abstract
Hide Abstract
Patients with renal cell carcinoma (RCC) and malignant melanoma (MM) have an increased risk of additional malignancies. We identified characteristics of MM and RCC associated with a patient developing both cancers.
Related JoVE Video
The state of prostate MRI in 2013.
Oncology (Williston Park, N.Y.)
PUBLISHED: 06-21-2013
Show Abstract
Hide Abstract
Compared with earlier prostate MRI techniques that suffered from relatively poor sensitivity and specificity for detecting prostate cancer because of their reliance predominantly on morphology, multiparametric prostate MRI (mpMRI) in 2013 provides a wealth of functional information that has made possible vastly improved detection and characterization of prostate cancer. Our aims in this article are to describe the various imaging sequences that comprise the mpMRI exam, as well as to review current literature on the strengths/weaknesses of these sequences; to delineate strategies for standardizing interpretation and reporting of MRI results; and finally, to expound on the role that prostate MRI currently does and potentially can play in clinical practice.
Related JoVE Video
Phase 1 trial of neoadjuvant radiation therapy before prostatectomy for high-risk prostate cancer.
Int. J. Radiat. Oncol. Biol. Phys.
PUBLISHED: 04-28-2013
Show Abstract
Hide Abstract
To evaluate, in a phase 1 study, the safety of neoadjuvant whole-pelvis radiation therapy (RT) administered immediately before radical prostatectomy in men with high-risk prostate cancer.
Related JoVE Video
Flaxseed-derived enterolactone is inversely associated with tumor cell proliferation in men with localized prostate cancer.
J Med Food
PUBLISHED: 04-10-2013
Show Abstract
Hide Abstract
Enterolactone and enterodiol, mammalian lignans derived from dietary sources such as flaxseed, sesame seeds, kale, broccoli, and apricots, may impede tumor proliferation by inhibiting activation of nuclear factor kappa B (NF?B) and vascular endothelial growth factor (VEGF). We examined the associations between urinary enterolactone and enterodiol with prostatic tumor expression of NF?B, VEGF, and Ki67 among 147 patients with prostate cancer who participated in a presurgical trial of flaxseed supplementation (30 g/day) for ~30 days. Urinary enterolignans and tissue biomarkers were determined by high-performance liquid chromatography and immunohistochemistry, respectively. After supplementation, we observed significant correlations between intakes of plant lignan and urinary concentrations of total enterolignans (?=0.677, P<.0001), enterolactone (?=0.676, P<.0001), and enterodiol (?=0.628, P<.0001). Importantly, we observed that total urinary enterolignans and enterolactone were significantly and inversely correlated with Ki67 in the tumor tissue (?=-0.217, P=.011, and ?=-0.230, P=.007, respectively), and a near-significant inverse association was observed for enterodiol (?=-0.159, P=.064). An inverse association was observed between enterolactone and VEGF (?=-0.143, P=.141), although this did not reach statistical significance. We did not observe an association between enterolignans and NF?B. In conclusion, flaxseed-derived enterolignans may hinder cancer cell proliferation via VEGF-associated pathways.
Related JoVE Video
The Role of Focal Therapy in the Management of Localised Prostate Cancer: A Systematic Review.
Eur. Urol.
PUBLISHED: 03-21-2013
Show Abstract
Hide Abstract
The incidence of localised prostate cancer is increasing worldwide. In light of recent evidence, current, radical, whole-gland treatments for organ-confined disease have being questioned with respect to their side effects, cancer control, and cost. Focal therapy may be an effective alternative strategy.
Related JoVE Video
Evolution of the concept of focal therapy for prostate cancer.
Oncology (Williston Park, N.Y.)
PUBLISHED: 03-07-2013
Show Abstract
Hide Abstract
The landscape of prostate cancer has been rapidly evolving, and technological advances in imaging and biopsy tools offer novel approaches to focal therapy. In this dynamic environment, the role of focal therapy for prostate cancer is being shaped both by advances in technology and by reconsidering the epidemiological and outcomes data for available treatments. Here we focus on the evolution of the concept of focal therapy and its potential roles in the management of prostate cancer.
Related JoVE Video
Short-term functional outcomes and complications associated with transperineal template prostate mapping biopsy.
Urology
PUBLISHED: 01-14-2013
Show Abstract
Hide Abstract
To assess the complications and erectile and urinary functional outcomes of transperineal template mapping biopsy (TTMB) of the prostate.
Related JoVE Video
Association between preoperative erectile dysfunction and prostate cancer features--an analysis from the Duke Prostate Center Database.
J Sex Med
PUBLISHED: 12-21-2011
Show Abstract
Hide Abstract
Erectile dysfunction (ED) is related to several co-morbidities including obesity, metabolic syndrome, cigarette smoking, and low testosterone, all of which have been reported to be associated with adverse prostate cancer features.
Related JoVE Video
Transatlantic Consensus Group on active surveillance and focal therapy for prostate cancer.
BJU Int.
PUBLISHED: 11-11-2011
Show Abstract
Hide Abstract
Whats known on the subject? and What does the study add? Active surveillance for prostate cancer is gaining increasing acceptance for low risk prostate cancer. Focal therapy is an emerging tissue preservation strategy that aims for treat only areas of cancer. Early phase trials have shown that side-effects can be significantly reduced using focal therapy. There is significant uncertainty in both active surveillance and focal therapy. This consensus group paper provides a road-map for clinical practice and research for both tissue-preserving strategies in the areas of patient population, tools for risk stratification and cancer localisation, treatment interventions as well as comparators and outcome measures in future comparative trials.
Related JoVE Video
Vitamin D(3) cryosensitization increases prostate cancer susceptibility to cryoablation via mitochondrial-mediated apoptosis and necrosis.
BJU Int.
PUBLISHED: 08-26-2011
Show Abstract
Hide Abstract
To investigate the effect and molecular mechanisms of action of Vitamin D(3) (VD(3) ) as a neo-adjunctive agent before cryosurgery in an effort to increase treatment efficacy for prostate cancer (CaP). To eliminate the potential for disease recurrence that exists at the periphery of the freeze lesion, where temperatures may be insufficient to destroy both androgen-sensitive (AS) and androgen-insensitive (AI) CaP.
Related JoVE Video
Complications and postoperative events after cryosurgery for prostate cancer.
BJU Int.
PUBLISHED: 08-22-2011
Show Abstract
Hide Abstract
There has been a call in the urological literature for standardized reporting of complications. To use strict criteria aiming to report our complications and other postoperative events in a cohort of men undergoing third-generation prostate cryosurgery.
Related JoVE Video
Factors predicting early and late phase decline of sexual health-related quality of life following radical prostatectomy.
J Sex Med
PUBLISHED: 07-19-2011
Show Abstract
Hide Abstract
The association between early and late phase sexual health-related quality of life (HRQoL) following radical prostatectomy (RP) is unclear. Moreover, factors that predict either early or late sexual HRQoL decline have not been fully investigated.
Related JoVE Video
Effect of low-fat diets on plasma levels of NF-?B-regulated inflammatory cytokines and angiogenic factors in men with prostate cancer.
Cancer Prev Res (Phila)
PUBLISHED: 07-15-2011
Show Abstract
Hide Abstract
Diet, nutritional status, and certain dietary supplements are postulated to influence the development and progression of prostate cancer. Angiogenesis and inflammation are central to tumor growth and progression, but the effect of diet on these processes remains uncertain. We explored changes in 50 plasma cytokines and angiogenic factors (CAF) in 145 men with prostate cancer enrolled in a preoperative, randomized controlled phase II trial with four arms: control (usual diet), low-fat (LF) diet, flaxseed-supplemented (FS) diet, and FS+LS diet. The mean duration of dietary intervention was 30 to 31 days. Among the individual arms, the largest number of significant changes (baseline vs. preoperative follow-up) was observed in the LF arm, with 19 CAFs decreasing and one increasing (P < 0.05). Compared with the control arm, 6 CAFs-including proangiogenic factors (stromal-cell derived-1?) and myeloid factors (granulocyte-colony-stimulating factor, macrophage colony-stimulating factor)-all decreased in the LF arm compared with controls; three and four CAFs changed in the FS and FS+LF arms, respectively. Weight loss occurred in the LF arms and significantly correlated with VEGF decreases (P < 0.001). The CAFs that changed in the LF arm are all known to be regulated by NF-?B, and a pathway analysis identified NF-?B as the most likely regulatory network associated with these changes in the LF arm but not in the FS-containing arms. These results suggest that a LF diet without flaxseed may reduce levels of specific inflammatory CAFs and suggests that the NF-?B pathway may be a mediator of these changes.
Related JoVE Video
Renal function outcomes after laparoscopic renal cryoablation.
J. Endourol.
PUBLISHED: 07-08-2011
Show Abstract
Hide Abstract
Laparoscopic cryoablation (LCA) has emerged as an alternative to conventional surgery for the management of a T(1) renal mass; however, only few data are available on its functional outcomes. We assessed renal function changes after LCA in patients with normal renal function (NRF) and preexisting chronic renal insufficiency (CRI).
Related JoVE Video
Renal tumors in solid organ recipients: clinical and pathologic features.
Urol. Oncol.
PUBLISHED: 06-29-2011
Show Abstract
Hide Abstract
Solid organ recipients are several times more likely to develop renal cell carcinoma (RCC) compared with the general population, but little is known about the features of these tumors. The aim of this study is to report on the characteristics of renal tumors in solid organ recipients compared with the general population.
Related JoVE Video
Radiation-induced erectile dysfunction using prostate-confined modern radiotherapy in a rat model.
J Sex Med
PUBLISHED: 06-16-2011
Show Abstract
Hide Abstract
The mechanisms of radiation-induced erectile dysfunction (ED) are unclear, as clinical studies are limited, and previous animal models were based on wide-field irradiation, which does not model current radiotherapy (RT) techniques.
Related JoVE Video
Treatment of localised renal cell carcinoma.
Eur. Urol.
PUBLISHED: 06-09-2011
Show Abstract
Hide Abstract
The increasing incidence of localised renal cell carcinoma (RCC) over the last 3 decades and controversy over mortality rates have prompted reassessment of current treatment.
Related JoVE Video
Utilization trends at a multidisciplinary prostate cancer clinic: initial 5-year experience from the Duke Prostate Center.
J. Urol.
PUBLISHED: 05-06-2011
Show Abstract
Hide Abstract
The multidisciplinary approach is becoming increasingly encouraged but little is known about the multidisciplinary experience compared to routine care. For patients with prostate cancer the goal is to provide evaluations by urologists, medical and radiation oncologists at a single visit. Although additional resources are required, this strategy may enhance the overall health care experience. We compared utilization determinants between a multidisciplinary and a urology prostate cancer clinic at Duke University Medical Center and identified factors associated with pursuing treatment at the university medical center for multidisciplinary clinic patients.
Related JoVE Video
Cigarette smoking is associated with advanced renal cell carcinoma.
J. Clin. Oncol.
PUBLISHED: 04-18-2011
Show Abstract
Hide Abstract
Cigarette smoking is a recognized risk factor for renal cell carcinoma (RCC), but little data are available on the association between smoking and RCC biology. We investigated the association between cigarette smoking and RCC stage in a large contemporary multiethnic surgical cohort.
Related JoVE Video
Understanding the pathological features of focality, grade and tumour volume of early-stage prostate cancer as a foundation for parenchyma-sparing prostate cancer therapies: active surveillance and focal targeted therapy.
BJU Int.
PUBLISHED: 04-13-2011
Show Abstract
Hide Abstract
• To better understand the biology and incidence of the cancer foci within the prostate through a comprehensive literature review and a review of our own data, to establish the current level of knowledge regarding the pathological foundation for active surveillance (AS) or focal therapy (FT).
Related JoVE Video
Percutaneous cryoablation of renal lesions with radiographic ice ball involvement of the renal sinus: analysis of hemorrhagic and collecting system complications.
AJR Am J Roentgenol
PUBLISHED: 03-24-2011
Show Abstract
Hide Abstract
The purpose of this study was to determine the incidence of collecting system and hemorrhagic complications resulting from CT-guided percutaneous cryoablation of renal tumors in which the radiographic ice ball abuts or involves the renal sinus.
Related JoVE Video
Acoustic radiation force impulse imaging of human prostates: initial in vivo demonstration.
Ultrasound Med Biol
PUBLISHED: 01-29-2011
Show Abstract
Hide Abstract
Reliably detecting prostate cancer (PCa) has been a challenge for current imaging modalities. Acoustic radiation force impulse (ARFI) imaging is an elasticity imaging method that uses remotely generated, focused acoustic beams to probe tissue stiffness. A previous study on excised human prostates demonstrated ARFI images portray various prostatic structures and has the potential to guide prostate needle biopsy with improved sampling accuracy. The goal of this study is to demonstrate the feasibility of ARFI imaging to portray internal structures and PCa in the human prostate in vivo. Custom ARFI imaging sequences were designed and implemented using a modified Siemens Antares™ scanner with a three-dimensional (3-D) wobbler, end-firing, trans-cavity transducer, EV9F4. Nineteen patients were consented and imaged immediately preceding surgical prostatectomy. Pathologies and anatomic structures were identified in histologic slides by a pathologist blinded to ARFI data and were then registered with structures found in ARFI images. The results demonstrated that when PCa is visible, it generally appears as bilaterally asymmetric stiff structures; benign prostatic hyperplasia (BPH) appears heterogeneous with a nodular texture; the verumontanum and ejaculatory ducts appears softer compared with surrounding tissue, which form a unique V shape; and the boundary of the transitional zone (TZ) forms a stiff rim separating the TZ from the peripheral zone (PZ). These characteristic appearances of prostatic structures are consistent with those found in our previous study of prostate ARFI imaging on excised human prostates. Compared with the matched B-mode images, ARFI images, in general, portray prostate structures with higher contrast. With the end-firing transducer used for this study, ARFI depth penetration was limited to 22 mm. Image contrast and resolution were decreased as compared with the previous ex vivo study due to the small transducer aperture. Even with these limitations, this study suggests ARFI imaging holds promise for guidance of targeted prostate needle biopsy and focal therapy, as well as aiding assessment of changes during watchful waiting/active surveillance.
Related JoVE Video
Salvage radiation in men after prostate-specific antigen failure and the risk of death.
Cancer
PUBLISHED: 01-03-2011
Show Abstract
Hide Abstract
A survival benefit has been observed with salvage radiation therapy (RT) for prostate-specific antigen (PSA) failure after radical prostatectomy (RP) in men with rapid rises in PSA doubling time (DT, < 6 months). Whether such a benefit exits in men with a protracted PSA rise in DT (? 6 months) is unclear and was examined in the current study.
Related JoVE Video
Clinical predictors of renal mass pathological features.
BJU Int.
PUBLISHED: 11-05-2010
Show Abstract
Hide Abstract
• To evaluate the influence of radiographic tumour size and other preoperative variables on the pathological characteristics of the lesion to determine the distribution of pathological features and assess preoperative risk factors for potentially aggressive versus probably indolent renal lesions.
Related JoVE Video
Prostate-specific antigen velocity based risk-adapted discontinuation of prostate cancer screening in elderly men.
BJU Int.
PUBLISHED: 11-02-2010
Show Abstract
Hide Abstract
• To evaluate weather prostate-specific antigen (PSA) velocity could be used to stratify patients at risk of death from prostate cancer (PCa) and be useful in aiding decision making regarding PSA screening in elderly men, as previous studies have shown that PSA velocity can predict PCa risk.
Related JoVE Video
Baseline PSA as a predictor of prostate cancer-specific mortality over the past 2 decades: Duke University experience.
Cancer
PUBLISHED: 07-01-2010
Show Abstract
Hide Abstract
A diagnosis of prostate cancer is not often predictive of death from prostate cancer because of competing causes of mortality. Identification of the risk of death from prostate cancer and death from all causes using information available at the time of baseline prostate-specific antigen (PSA) measurement appears to be particularly pertinent.
Related JoVE Video
Pathological T2 sub-divisions as a prognostic factor in the biochemical recurrence of prostate cancer.
BJU Int.
PUBLISHED: 06-18-2010
Show Abstract
Hide Abstract
To determine the adequacy of T2 prostate cancer (PCa) sub-staging as an independent Predictor of biochemical disease-free survival (bDFS) after radical prostatectomy.
Related JoVE Video
Adjuvant versus salvage radiation therapy for prostate cancer and the risk of death.
BJU Int.
PUBLISHED: 06-18-2010
Show Abstract
Hide Abstract
To investigate whether salvage radiation therapy (RT) for prostate-specific antigen (PSA) failure can provide the same result as adjuvant RT, which decreases the risk of all-cause mortality (ACM) for men with positive margins (R1), or extra-capsular or seminal vesicle extension (pT3).
Related JoVE Video
Morphology of hypoxia following cryoablation in a prostate cancer murine model: its relationship to necrosis, apoptosis and, microvessel density.
Cryobiology
PUBLISHED: 06-15-2010
Show Abstract
Hide Abstract
The aim of this study is to investigate the tumor tissue changes in terms of hypoxia and demonstrate its relationship to vascularity and apoptosis following therapeutic cryoablation in a prostate tumor murine model. Total 67 male C57BL/J6 mice were assigned into sham-operation group and cryoablation group. Murine prostate tumors (RM-9) were inoculated subcutaneously in a right hind leg and treated with cryotherapy. Of 30 mice, tumor volumes were measured for 12 days following operation. Of 37 mice, tumor tissues were harvested in 24h following operation, and histological/molecular changes were analyzed. Hematoxylin and eosin or immunohistochemical staining were utilized to quantify tumor necrosis, hypoxia (pimonidazole), vascularization (CD31), and apoptosis (cleaved caspase-3). The results showed that cryoablated tumors demonstrated significant delayed growth following treatment compared to controls. Pathological analysis revealed that the severity of hypoxia increased in the cryoablation arm compared to controls. Necrotic and apoptotic populations were also found to be increased in the cryoablation arm (P=0.028 and 0.021). Hypoxia demonstrated a positive correlation with necrosis (r=0.520, P=0.001) and apoptosis (r=0.474, P=0.003), while showing negative correlation with microvessel density (MVD) (r=-0.361, P=0.021). We concluded that in the peripheral areas from the cryoneedle impact site, strong hypoxic responses were found, which may play important role in tumor freezing injury. To our knowledge, this is the first report describing cryoablation-mediated changes of hypoxia at a molecular level in the prostate cancer murine model.
Related JoVE Video
Contemporary results of focal therapy for prostate cancer using cryoablation.
J. Endourol.
PUBLISHED: 05-07-2010
Show Abstract
Hide Abstract
The concept of focal therapy is rapidly evolving and gaining popularity from both physician and patient perspectives. We review the rationale, candidate selection, and results of the first clinical studies of focal cryoablation for selected patients with low volume and low- to low-moderate-risk features of prostate cancer as an alternative to whole-gland treatment. In spite of improved understanding of the tumor biology of early stage disease, we currently have limited tools to select appropriate patients with low- to low-moderate risk unifocal or unilateral prostate cancer who may be amenable to focal therapy. From a technical point, a number of ablative treatment options for focal therapy are available, with cryoablation having the most clinical experience. Recently, several reports have been published from single and multi-institutional studies that discuss focal therapy as a reasonable balance between cancer control and quality-of-life outcomes. Retrospective pathologic data from large prostatectomy series, however, do not clearly reveal valid and reproducible criteria to select appropriate candidates for focal cryoablation because of the complexity of tumorigenesis in early stage disease. At this time, a more feasible option remains hemiablation of the prostate with reasonable certainty about the absence of clinically significant cancer lesion(s) on the contralateral side of the prostate based on three-dimensional transperineal prostate biopsy mapping studies. Minimally invasive, parenchyma-preserving cryoablation can be considered as a potential feasible option in the treatment armamentarium of early stage, localized prostate cancer in appropriately selected candidates. There is a need to further test this technique in randomized, multicenter clinical trials.
Related JoVE Video
Focal cryotherapy for prostate cancer.
Curr Urol Rep
PUBLISHED: 04-29-2010
Show Abstract
Hide Abstract
Focal therapy for prostate cancer has emerged an interesting concept as a less morbid option for the treatment of localized low-risk disease. Despite the growing interest in focal therapy, this approach has not yet gained sufficient popularity nor provided enough data to be discussed outside the experimental application. Herein we summarize the available data on focal cryotherapy and focus on the targets to be achieved in order to increase the applicability of focal cryotherapy to clinical practice. A cautious approach to candidate selection and generation of solid scientific data that would result in wide consensus on patient selection strategies and follow-up schemes would provide the tools necessary to take the path of focal therapy. Currently available focal cryotherapy data demonstrate excellent short-term results and a favorable quality-of-life profile. Although the future role of focal treatment is debated, a growing amount of science is generated in support of this minimally invasive approach.
Related JoVE Video
Prostate biopsy in selecting candidates for hemiablative focal therapy.
J. Endourol.
PUBLISHED: 04-08-2010
Show Abstract
Hide Abstract
Focal therapy (FT) for the management of clinically localized prostate cancer (PCa) is growing from a concept to reality because of increased interest of both patients and physicians. Selection protocols, however, are yet to be established. We discuss the role of prostate biopsy in candidate selection for FT and highlight the different strategies and technical aspects of the use of prostate biopsy in this setting. In our opinion, prostate biopsy plays a major role in the selection process and tailoring appropriate treatment strategy to the patient. FT necessitates dedicated biopsy schemes that would reliably predict the extent, nature, and location of PCa in selected patients. Currently, there is insufficient scientific evidence to propose a specific biopsy scheme that could fit every candidate, providing accurate characterization of the disease in the individual patient. Further research is necessary to establish solid selection protocols that would reliably identify appropriate candidates for FT of PCa.
Related JoVE Video
Prostate cancer: an evolving paradigm.
J. Endourol.
PUBLISHED: 04-07-2010
Show Abstract
Hide Abstract
Since at least the early 1990s, stage and risk migration have been seen in patients with prostate cancer, likely corresponding to the institution of prostate specific antigen (PSA) screening in health systems. Preoperative risk factors, including PSA level and clinical stage, have decreased significantly. These improved prognostic variables have led to a larger portion of men being stratified with low-risk disease, as per the classification of DAmico and associates. This, in turn, has corresponded with more favorable postoperative variables, including decreased extraprostatic tumor extension and prolonged biochemical-free recurrence rates. The advent of focal therapy is bolstered by findings of increased unilateral disease with decreased tumor volume. Increasingly, targeted or delayed therapies may be possible within the current era of lower risk disease.
Related JoVE Video
Acoustic radiation force impulse imaging of human prostates ex vivo.
Ultrasound Med Biol
PUBLISHED: 03-31-2010
Show Abstract
Hide Abstract
It has been challenging for clinicians using current imaging modalities to visualize internal structures and detect lesions inside human prostates. Lack of contrast among prostatic tissues and high false positive or negative detection rates of prostate lesions have limited the use of current imaging modalities in the diagnosis of prostate cancer. In this study, acoustic radiation force impulse (ARFI) imaging is introduced to visualize the anatomical and abnormal structures in freshly excised human prostates. A modified Siemens Antares ultrasound scanner (Siemens Medical Solutions USA Inc., Malvern, PA) and a Siemens VF10-5 linear array were used to acquire ARFI images. The transducer was attached to a three-dimensional (3-D) translation stage, which was programmed to automate volumetric data acquisition. A depth dependent gain (DDG) method was developed and applied to 3-D ARFI datasets to compensate for the displacement gradients associated with spatially varying radiation force magnitudes as a function of depth. Nine human prostate specimens were collected and imaged immediately after surgical excision. Prostate anatomical structures such as seminal vesicles, ejaculatory ducts, peripheral zone, central zone, transition zone and verumontanum were visualized with high spatial resolution and in good agreement with McNeals zonal anatomy. The characteristic appearance of prostate pathologies, such as prostate cancerous lesions, benign prostatic hyperplasia, calcified tissues and atrophy were identified in ARFI images based upon correlation with the corresponding histologic slides. This study demonstrates that ARFI imaging can be used to visualize internal structures and detecting suspicious lesions in the prostate and appears promising for image guidance of prostate biopsy.
Related JoVE Video
Complications of laparoscopic and percutaneous renal cryoablation in a single tertiary referral center.
Eur. Urol.
PUBLISHED: 03-19-2010
Show Abstract
Hide Abstract
Laparoscopic cryoablation (LCA) and percutaneous cryoablation (PCA) of small renal masses have gained popularity, but only limited data exist on the complication rates.
Related JoVE Video
Predicting occult multifocality of renal cell carcinoma.
Eur. Urol.
PUBLISHED: 03-05-2010
Show Abstract
Hide Abstract
Multifocal renal cell carcinoma (RCC) has been reported in up to 25% of all radical nephrectomy specimens. Modern imaging tends to underestimate the rate of multifocality. Recognition of multifocality before treatment may guide physicians and patients to the type of intervention and tailor long-term follow-up.
Related JoVE Video
111-In-capromab pendetide imaging using hybrid-? camera-computer tomography technology is not reliable in detecting seminal vesicle invasion in patients with prostate cancer.
Urol. Oncol.
PUBLISHED: 03-02-2010
Show Abstract
Hide Abstract
In this study, we evaluate the diagnostic utility of a hybrid ?-camera-computer tomography (SPECT-CT) indium-111 (111-In)-capromab pendetide scan in detecting seminal vesicle invasion (SVI) in select patients evaluated for primary surgical treatment of prostate cancer (CaP).
Related JoVE Video
Predicting biopsy-proven prostate cancer recurrence following cryosurgery.
Urol. Oncol.
PUBLISHED: 02-23-2010
Show Abstract
Hide Abstract
Prostate cancer (CaP) cryosurgery utilizes PSA nadir level and radiotherapy criteria as surrogates for success. We attempted to correlate PSA doubling time (PSAdt) and time of undetectable PSA (TUPSA) with biopsy-proven cancer recurrence (BPR) in men treated with primary third-generation cryotherapy for clinically localized CaP.
Related JoVE Video
Impact of postoperative prostate-specific antigen disease recurrence and the use of salvage therapy on the risk of death.
Cancer
PUBLISHED: 02-18-2010
Show Abstract
Hide Abstract
This report evaluated whether biochemical recurrence (BCR) as a time-dependent covariate (t) after radical prostatectomy (RP) for prostate cancer was associated with the risk of death and whether salvage therapy with radiotherapy (RT) and/or hormonal therapy (HT) can lessen this risk
Related JoVE Video
Focal therapy for prostate cancer: possibilities and limitations.
Eur. Urol.
PUBLISHED: 02-01-2010
Show Abstract
Hide Abstract
A significant proportion of patients diagnosed with prostate cancer have well-differentiated, low-volume tumors at minimal risk of impacting their quality of life or longevity. The selection of a treatment strategy, among the multitude of options, has enormous implications for individuals and health care systems.
Related JoVE Video
Role of vitamin D(3) as a sensitizer to cryoablation in a murine prostate cancer model: preliminary in vivo study.
Urology
PUBLISHED: 01-26-2010
Show Abstract
Hide Abstract
Calcitriol has been reported to have antitumor efficacy in several cancers. In this study, we hypothesized that calcitriol may potentially function as a cryosensitizer that can enhance cryoablation, and we investigated several molecular marker changes in a murine model of prostate cancer.
Related JoVE Video
Tumor percent involvement predicts prostate specific antigen recurrence after radical prostatectomy only in men with smaller prostate.
J. Urol.
PUBLISHED: 01-20-2010
Show Abstract
Hide Abstract
We determined the predictive power of tumor percent involvement on prostate specific antigen recurrence in patients when stratified by prostate weight.
Related JoVE Video
Recent advances in focal therapy of prostate and kidney cancer.
F1000 Med Rep
PUBLISHED: 01-18-2010
Show Abstract
Hide Abstract
The concept of focal therapy in oncologic surgery refers to maximizing healthy tissue preservation while maintaining excellent cancer control outcomes. Herein, we address the recent advantages in the field of focal therapy for both kidney and prostate cancer, focusing on technological achievements and future perspectives.
Related JoVE Video
Initial prostate specific antigen 1.5 ng/ml or greater in men 50 years old or younger predicts higher prostate cancer risk.
J. Urol.
PUBLISHED: 01-18-2010
Show Abstract
Hide Abstract
Studies show that initial prostate specific antigen higher than the median in young men predicts a subsequent higher risk of prostate cancer. To our knowledge this relationship has not been studied in patients stratified by race.
Related JoVE Video
Characterizing stiffness of human prostates using acoustic radiation force.
Ultrason Imaging
PUBLISHED: 01-07-2010
Show Abstract
Hide Abstract
Acoustic Radiation Force Impulse (ARFI) imaging has been previously reported to portray normal anatomic structures and pathologies in ex vivo human prostates with good contrast and resolution. These findings were based on comparison with histological slides and McNeals zonal anatomy. In ARFI images, the central zone (CZ) appears darker (smaller displacement) than other anatomic zones and prostate cancer (PCa) is darker than normal tissue in the peripheral zone (PZ). Since displacement amplitudes in ARFI images are determined by both the underlying tissue stiffness and the amplitude of acoustic radiation force that varies with acoustic attenuation, one question that arises is how the relative displacements in prostate ARFI images are related to the underlying prostatic tissue stiffness. In linear, isotropic elastic materials and in tissues that are relatively uniform in acoustic attenuation (e.g., liver), relative displacement in ARFI images has been shown to be correlated with underlying tissue stiffness. However, the prostate is known to be heterogeneous. Variations in acoustic attenuation of prostatic structures could confound the interpretation of ARFI images due to the associated variations in the applied acoustic radiation force. Therefore, in this study, co-registered three-dimensional (3D) ARFI datasets and quantitative shear wave elasticity imaging (SWEI) datasets were acquired in freshly-excised human prostates to investigate the relationship between displacement amplitudes in ARFI prostate images and the matched reconstructed shear moduli. The lateral time-to-peak (LTTP) algorithm was applied to the SWEI data to compute the shear-wave speed and reconstruct the shear moduli. Five types of prostatic tissue (PZ, CZ, transition zone (TZ) and benign prostatic hyperplasia (BPH), PCa and atrophy) were identified, whose shear moduli were quantified to be 4.1 +/- 0.8 kPa, 9.9 +/- 0.9 kPa, 4.8 +/- 0.6 kPa, 10.0 +/- 1.0 kPa and 8.0 kPa, respectively. Linear regression was performed to compare ARFI displacement amplitudes and the inverse of the corresponding reconstructed shear moduli at multiple depths. The results indicate an inverse relation between ARFI displacement amplitude and reconstructed shear modulus at all depths. These findings support the conclusion that ARFI prostate images portray underlying tissue stiffness variations.
Related JoVE Video
Biopsy accuracy in identifying unilateral prostate cancer depends on prostate weight.
Urol. Oncol.
PUBLISHED: 01-06-2010
Show Abstract
Hide Abstract
To evaluate the association between prostate weight and the diagnostic performance of routine biopsy schemes in detecting unilateral prostate cancer (PCa) that may be amenable to focal therapy.
Related JoVE Video
Effect of age and pathologic Gleason score on PSA recurrence: analysis of 2911 patients undergoing radical prostatectomy.
Urology
PUBLISHED: 12-08-2009
Show Abstract
Hide Abstract
To clarify the relationship between age and pathologic Gleason score and their effect on prostate-specific antigen recurrence (PSAR).
Related JoVE Video
Utilization of (111)In-Capromab pendetide SPECT-CT for detecting seminal vesicle invasion with recurrent prostate cancer after primary in situ therapy.
Int. J. Urol.
PUBLISHED: 10-16-2009
Show Abstract
Hide Abstract
The aim of this study was to evaluate the diagnostic value of a hybrid (111)In-capromab pendetide fused computed tomography (CT) scan in detecting seminal vesicle invasion (SVI) in the setting of recurrent prostate cancer following primary in situ therapy. The study population comprised 59 patients, who biochemically failed primary in situ treatment based on American Society for Therapeutic Radiology and Oncology criteria. The patients underwent an (111)In-capromab pendetide/CT scan at the time of biochemical failure with a prostate (12-core) and seminal vesicle (SV) (8-core) biopsy. The diagnostic properties of the scan and magnetic resonance imaging (MRI) in detecting SVI compared to an SV biopsy were calculated. In total, eight (14%) patients had a positive SV biopsy after primary in situ prostate cancer treatment. Nine (15%) patients had positive uptake of the scan in the SV. When comparing the SV scan results to the SV biopsy, the sensitivity, specificity, positive predictive value, and negative predictive value were 37.5%, 88.2%, 33.3%, and 90.0% (95% confidence interval: 0.44-0.81), respectively. In contrast, the ability of MRI to detect SVI was 50.0%, 81.3%, 40.0%, and 86.7% (95% confidence interval: 0.46-0.85), respectively. Although the sensitivity and positive predictive value of the (111)In-capromab pendetide/CT scan are low, its specificity and negative predictive value are high. Based on these findings, the ability of the (111)In-capromab pendetide/CT scan to detect SVI seems to be comparable with MRI.
Related JoVE Video
Predicting unilateral prostate cancer on routine diagnostic biopsy: sextant vs extended.
BJU Int.
PUBLISHED: 10-10-2009
Show Abstract
Hide Abstract
To compare the diagnostic properties of routine office-based sextant and extended biopsies for unilateral prostate cancer, as validated by final pathology, because focal therapy of prostate cancer is gaining acceptance as a viable treatment option and thus patient selection is of paramount consideration.
Related JoVE Video
Bisphosphonates in oncology: evidence for the prevention of skeletal events in patients with bone metastases.
Drug Des Devel Ther
PUBLISHED: 09-21-2009
Show Abstract
Hide Abstract
Bone metastases frequently occur in patients with advanced solid tumors, particularly breast and prostate cancers, and nearly all patients with multiple myeloma have some degree of skeletal involvement. The strides made in treating these primary tumors have extended median survival times and thereby increased patient risk for skeletal-related events (SREs), including pathologic fractures, spinal cord compression, need for palliative radiation therapy or surgery to bone, and hypercalcemia. Bisphosphonates, inhibitors of osteoclastic bone resorption that were first established as treatment of osteoporosis, have been shown to prevent and/or delay SREs related to malignancy. The results of a large, randomized phase 3 study comparing zoledronic acid and pamidronate in breast cancer or multiple myeloma patients with osteolytic lesions showed that the incidence of SREs, time to first SRE, and risk of developing a SRE were similar between treatment groups. However, in patients with solid tumors (excluding breast or prostate cancer) metastatic to the bone, only zoledronic acid has demonstrated clinical efficacy. Although bone turnover marker levels, such as N-telopeptide of type I collagen, have been shown to correlate with clinical response, additional studies are needed to validate their ability to predict response to bisphosphonate therapy.
Related JoVE Video
A retrospective comparison of anesthetic management of robot-assisted laparoscopic radical prostatectomy versus radical retropubic prostatectomy.
J Clin Anesth
PUBLISHED: 08-22-2009
Show Abstract
Hide Abstract
To compare anesthetic management and postoperative outcomes in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP) and radical retropubic prostatectomy (RRP) with general anesthesia.
Related JoVE Video
Prostate-specific antigen-based risk-adapted discontinuation of prostate cancer screening in elderly African American and Caucasian American men.
Urology
PUBLISHED: 08-19-2009
Show Abstract
Hide Abstract
To evaluate the relationship between initial prostate-specific antigen (PSA) and prostate cancer (PCa) risk in elderly African American (AA) and Caucasian American (CA) men.
Related JoVE Video
Analysis of urinary function using validated instruments and uroflowmetry after primary and salvage prostate cryoablation.
Urology
PUBLISHED: 08-15-2009
Show Abstract
Hide Abstract
To evaluate changes in urinary function after cryoablation for clinically localized prostate cancer and to investigate risk factors that predict changes in urinary function after surgery.
Related JoVE Video
Current salvage methods for recurrent prostate cancer after failure of primary radiotherapy.
BJU Int.
PUBLISHED: 07-02-2009
Show Abstract
Hide Abstract
We reviewed the current salvage methods for patients with local recurrent prostate cancer after primary radiotherapy (RT), using a search of relevant Medline/PubMed articles published from 1982 to 2008, with the following search terms: radiorecurrent prostate cancer, local salvage treatment, salvage radical prostatectomy (RP), salvage cryoablation, salvage brachytherapy, salvage high-intensity focused ultrasound (HIFU), and permutations of the above. Only articles written in English were included. The objectives of this review were to analyse the eligibility criteria for careful selection of appropriate patients and to evaluate the oncological results and complications for each method. There are four whole-gland re-treatment options (salvage RP, salvage cryoablation, salvage brachytherapy, salvage HIFU) for RT failure, although others might be in development or investigations. Salvage RP has the longest follow-up with acceptable oncological results, but it is a challenging technique with a high complication rate. Salvage cryoablation is a feasible option, especially using third-generation technology, whereby the average biochemical disease-free survival rate is 50-70% and there are fewer occurrences of severe complications such as recto-urethral fistula. Salvage brachytherapy, with short-term cancer control, is comparable to other salvage methods but depends on cumulative dosage limitation to target tissues. HIFU is a relatively recent option in the salvage setting. Both salvage brachytherapy and HIFU require more detailed studies with intermediate and long-term follow-up. As these are not prospective, randomized studies and the definitions of biochemical failure varied, there are limited comparisons among these different salvage methods, including efficacy. In the focal therapy salvage setting, the increased use of thermoablative methods for eligible patients might contribute to reducing complications and maintaining quality of life. The problem to effectively salvage patients with locally recurrent disease after RT is the lack of diagnostic examinations with sufficient sensitivity and specificity to detect local recurrence at an early curable stage. Therefore, a more strict definition of biochemical failure, improved imaging techniques, and accurate specimen mapping are needed as diagnostic tools. Furthermore, universal selection criteria and an integrated definition of biochemical failure for all salvage methods are required to determine which provides the best oncological efficacy and least comorbidity.
Related JoVE Video
Altered male physiologic function after surgery for prostate cancer: couple perspective.
Int Braz J Urol
PUBLISHED: 06-29-2009
Show Abstract
Hide Abstract
Both the diagnosis of prostate cancer (PCa) and the physiologic outcomes of surgical treatment impact the males psychological sphere. However, current research advocates a refocusing of outcomes directed to the PCa "couple". Herein we acquire insight into perspective and concordance regarding male physiological function from the standpoint of a couple recovering from PCa surgery.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.