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At least 55 records · Page 3Linked to original sources
PubMed2004

Effectiveness of percent free prostate specific antigen as a predictor of prostate cancer detection on repeat biopsy.

BACKGROUND: The aim of this study was to identify predictors that can increase the accuracy of detecting prostate cancer on subsequent biopsies. METHODS: Between 1998 and 2003, a total of 235 men with prostate specific antigen (PSA) levels between 4.0 and 20 ng/mL underwent one or more systematic needle biopsies of the prostate. Of these men, 73 (31.1%) underwent one repeat biopsy and 26 (11.1%) underwent two or more repeat biopsies. We evaluated the results of prostate biopsies in relation to the morbidity of prostate cancer detected on repeat biopsies. RESULTS: Of the 73 men who underwent repeat biopsy, 16 (21.9%) had prostate cancer. Twenty-six men with one negative re-biopsy underwent two or more repeat biopsies, and five of these patients were found to have early stage prostate cancer. On repeat biopsy, there was a significant difference in percent free PSA between the cancer-detected group and the no-cancer-detected group (P < 0.01). A receiver operating characteristics (ROC) curve gave an optimal cut-off value for percent free PSA of 11%, demonstrating a significant difference in the cancer detection rate on repeat biopsy (P = 0.0009). Analysis of the data for re-biopsies showed that cancer-detected cases showed a raised PSA value and a simultaneously reduced percent free PSA (these differences were statistically significant). CONCLUSIONS: A low percent free PSA level increased the probability of a positive result in repeat biopsy. An increase in the accuracy of detecting cancer, especially on repeat biopsy, will promote the detection of more early stage prostate cancer.

Aged↗
PubMed2002

[Fluorescent endoscopy superior to white light endoscopy. Detecting cancers of the urinary bladder earlier].

5-aminolevulinic acid-induced fluorescence endoscopy (AFE) has enormously increased the effectiveness of early cancer detection. This was first shown for cancer of the bladder. After application of 5-aminolevulinic acid (5-ALA) endogenous protoporphyrin IX (PP IX) accumulates in tumor tissue. When such tissue is then irradiated with blue light, the neoplastic areas can be identified by red fluorescence and, in the case of the bladder, can be removed by transurethral resection (TUR) or laser coagulation in the same endoscopic session. The great advantage of this highly sensitive technique (95%) is to be seen in particular in the detection of flat urothelial neoplastic lesions--until recently a deficit in conventional white-light endoscopy. Initial investigations show that improved early detection and the reduction in the residual tumor rate lead to longer recurrence-free intervals.

Aminolevulinic Acid↗
PubMed1983

Cancer detection in the periodic physical examination.

The periodic physical exam is the ideal time for the primary physician to detect cancer at an early stage. With certain points in mind the physician can rapidly screen for suggestive signs of cancer during the physical examination. Certain procedures, laboratory and x-ray examinations, aid in this detection and should be part of the total examination.

Abdominal Neoplasms↗
PubMed2005

Computer-aided detection (CAD) of cancers detected on double reading by one reader only.

We evaluated the role of computer-aided detection (CAD) in cancers undergoing double reading and detected by one reader only. A series of 33 cancers, originally missed by the first reader and detected by the second reader, and 75 negative controls were processed to assess CAD sensitivity, and was read by the six radiologists who originally missed the cancers with the help of CAD printouts. CAD case-based sensitivity, specificity and positive predictive value were 51.5%, 18.6% and 21.7%, respectively. Average sensitivity of all radiologists in all cancers in the series was 74.7%, being higher for CAD+ (86.2%) than for CAD- (62.5%) cancers (P<0.01). When reading cancer cases that they had originally missed, radiologists had a sensitivity of 75.8%, which was higher for CAD+ (100.0%) than for CAD- (58.3%) cancers. The average recall rate was 14.2%, the majority of recalls (45 out of 64) occurring for lesions marked by CAD. CAD may help in detecting at most half of cancers missed at a single reading but detected by a second reader.

Breast Neoplasms↗
PubMed1986

The role of a questionnaire and four biochemical markers to detect cancer risk in a symptomatic population.

The roles of a self-completed symptom questionnaire and four biochemical markers of disease were assessed to determine risk for gastric and colorectal cancer from within a hospital population and a random population. Eight-six patients with cancer, 168 subjects with benign conditions of the stomach and large bowel and 720 individuals from the community at large were investigated. Multivariate analyses of the questionnaire and biochemical data were performed individually and in combination using a data set comprising 54 cancer subjects, 80 patients with benign disease and 200 random individuals. The most favourable predictive equation derived was then applied to the remaining data set to determine its efficacy. In the primary analyses the questionnaire data identified 32 (60%) cancers successfully and using the biochemical markers alone 36 (67%) patients were also correctly classified as cancer bearing. However, the combination of the questionnaire and marker data improved the sensitivity for cancer to 50 cancers detected (92%) (P less than 0.02). Using the predictive equation from this combination of data to identify risk in the second data set 28/32 (88%) cancers were correctly identified with only an 11% false positive rate. An 18 month follow-up for the non-cancer group has to date revealed only one cancer (ca. pancreas). In this limited study, multivariate analysis of questionnaire and biochemical marker data does successfully identify individuals at "high risk' of harbouring gastric or colorectal cancer within a symptomatic population and may have a role in determining priority for investigation for a symptomatic individual.

Aged↗
PubMed2005

Combined analysis of morphology and fluorescence in situ hybridization significantly increases accuracy of bladder cancer detection in voided urine samples.

OBJECTIVES: To evaluate a combined analysis approach that involves cytologic evaluation and fluorescence in situ hybridization analysis for detecting cancer cells in voided urine samples using an automated scanning station. METHODS: Voided urine samples from 41 patients suspected of having transitional cell carcinoma were stained with May-Grünwald Giemsa stain, scanned for atypical or suspicious cells, destained, and hybridized with a mixture of fluorescent-labeled probes. Samples were tested using either the UroVysion probe or by a mix of chromosomes 3, 7, and 17 centromeric probes. A case was regarded as positive when at least one cell was abnormal in both aspects, morphology and fluorescence in situ hybridization. Patients were evaluated concomitantly by cytology, cytoscopy, and biopsy, if indicated. RESULTS: Overall, 26 samples were positive by combined analysis. Biopsy-proven transitional cell carcinoma was positive by combined analysis in all cases (100%) and in 13 cases (61.9%) by cytology (P = 0.0133). The advantage of the combined analysis was noted mostly in low-grade and superficial tumors for which the sensitivity of cytology reached 30% (P = 0.023) and 27.27% (P = 0.0133), respectively. Specificity was 100%. CONCLUSIONS: Our results have shown that combined analysis for the presence of transitional cell carcinoma cells is a powerful tool, providing high sensitivity and specificity, and may offer a new scheme for bladder cancer management.

Adult↗
PubMed1976

Carboxyl-labeled 11C-1-aminocyclopentanecarboxylic acid, a potential agent for cancer detection.

Carboxyl-labeled 11C-1-aminocyclopentanecarboxylic acid (11C-ACPC) has been prepared in multimillicurie amounts. The conversion of H11CN to 11C-ACPC (t1/2 = 20.4 min) was accomplished by a rapid (20-min) two-step high-temperature modification of the Bücherer-Strecker amino acid synthesis technique, which should be applicable at other accelerator installations. Purification was by ion exchange techniques. Animal studies have indicated that 11C-ACPC is a potential tumor-localizing agent for detecting cancer in humans by nuclear medicine scanning techniques.

Animals↗
PubMed1996

A comparison of axillary node status between cancers detected at the prevalence and first incidence breast screening rounds.

Screen-detected breast cancers are smaller than those detected in symptomatic populations and, for any given size, they are associated with fewer lymph node metastases. The management of axillary lymph nodes in patients with screen-detected breast cancer remains controversial. We have previously reported that prevalence (initial screen)-detected cancers are associated with nodal metastases in 17.4% of cases overall. Cancers < or = 10 mm, of any grade, are associated with metastases in only 5% of cases, and grade I cancers <30 mm are not associated with metastases. This led to our recommendation that axillary surgery is unnecessary for these groups of women. The present study compared the nodal status of cancers detected at the prevalence and first incidence (second) screens in order to determine whether our recommendation is appropriate for cancers detected at the first incidence screen. Overall, 30.1% of cancers detected in the first incidence screen presented axillary nodal metastases. At all size ranges, cancers detected at the first incidence screen were associated with significantly more lymph node metastases than prevalence-detected cancers. In particular, cancers < or = 10 mm were associated with metastases in 14.3% of cases. With the possible exception of grade I cancers, we believe that surgical staging of the axilla is essential for cancers detected at the first incidence screen, irrespective of size.

Aged↗
PubMed2006

Computer simulated additional deep apical biopsy enhances cancer detection in palpably benign prostate gland.

OBJECTIVES: The objective of this study was to use computer simulation to investigate the optimal biopsy scheme for enhancing the detection of cancer in palpably benign prostate glands. METHODS: The predominant distribution of palpably benign prostate cancer is anterior apex to mid-prostate. We used computer simulation to optimize apical samplings and to simulate the biopsy procedure, including angle and length. A total of 254 consecutive patients with palpably benign prostate glands underwent sextant biopsy plus two additional deep apical biopsies. RESULTS: Based on the computer simulation, lateral sextant and two additional medially located deep apical cores with a sagittal penetration angle of 80 degrees had the maximum cancer detection. Of the 254 patients, 58 (22.8%) had prostate cancer: 28 (48.3%) were positive only at the standard sextant sites, 12 (20.7%) were positive exclusively at the deep apical sites, and the remaining 18 (31.0%) were positive at both sites. Patients with gray-zone prostate-specific antigen (PSA) ranges of 4.1-10.0 ng/mL had increased cancer detection rates of 24% compared to sextant biopsy. Enhanced cancer detection by the deep apical biopsy was also evident in patients with a prostatic volume >40 cm3 (by 36.4%) and PSA 2.1-4.0 ng/mL (by 13.3%). CONCLUSIONS: Using a computer simulation-based biopsy scheme with deep apical sampling cores enhanced the detection of prostate cancer in palpably benign glands, especially in men with PSA ranges of 4.1-10.0 ng/mL or a gland volume of >40 cm3. Our approach with fewer sampling cores may have been more cost-effective than other extensive biopsy schemes, but further studies with larger samples are warranted.

Aged↗
PubMed2005

Prostate cancer detection with digital rectal examination, prostate-specific antigen, transrectal ultrasonography and biopsy in clinical urological practice.

OBJECTIVE: To evaluate the utility of digital rectal examination (DRE), prostate specific antigen (PSA) and transrectal ultrasonography and biopsy (TRUSB) in detecting prostate cancer in one teaching-hospital urological practice. PATIENTS AND METHODS: In all, 2800 consecutive patients had TRUSB as outpatients by one urologist, the indications for which were a raised or rising PSA level or an abnormal DRE. In addition, the indications for repeat TRUSB included previous abnormal histology, e.g. suspicious areas or atypia or high-grade prostatic intraepithelial neoplasia. All data were collected prospectively. RESULTS: Of 2800 TRUSB, 223 were known cases of prostate cancer (previously diagnosed from transurethral prostatectomy chips or after radical prostatectomy) and were excluded from the analysis. There were 2194 initial and 383 repeat TRUSB; of the former patients, 1129 were found to have prostate cancer, giving a cancer-detection rate of 52%. The positive predictive values (PPVs) for patients with a normal DRE and PSA of < 4, 4-10 and > 10 ng/mL were 9%, 31% and 48%, respectively; the corresponding PPVs for patients with an abnormal DRE and the same PSA levels were 27%, 67% and 85%, respectively. Of the 383 repeat TRUSB, the cancer-detection rate was 31% for the first repeat and 28% for the second. CONCLUSIONS: The present values are higher than those reported previously, because these patients were within a clinical urological practice, and the indications for and methods of TRUSB have changed in recent years, such that more lateral areas were biopsied. These values are useful in helping clinicians to counsel patients about the probability of detecting cancer.

Aged↗
PubMed2004

Sensitivity of noncommercial computer-aided detection system for mammographic breast cancer detection: pilot clinical trial.

PURPOSE: To evaluate a noncommercial computer-aided detection (CAD) program for breast cancer detection with screening mammography. MATERIALS AND METHODS: A CAD program was developed for mammographic breast cancer detection. The program was applied to 2,389 patients' screening mammograms at two geographically remote academic institutions (institutions A and B). Thirteen radiologists who specialized in breast imaging participated in this pilot study. For each case, the individual radiologist performed a prospective Breast Imaging Reporting and Data System (BI-RADS) assessment after viewing of the screening mammogram. Subsequently, the radiologist was shown CAD results and rendered a second BI-RADS assessment by using knowledge of both mammographic appearance and CAD results. Outcome analysis of results of examination in patients recalled for a repeat examination, of biopsy, and of 1-year follow-up examination was recorded. Correct detection with CAD included a computer-generated mark indicating a possible malignancy on craniocaudal or mediolateral oblique views or both. RESULTS: Eleven (0.46%) of 2,389 patients had mammographically detected nonpalpable breast cancers. Ten (91%) of 11 (95% CI: 74%, 100%) cancers were correctly identified with CAD. Radiologist sensitivity without CAD was 91% (10 of 11; 95% CI: 74%, 100%). In 1,077 patients, follow-up findings were documented at 1 year. Five (0.46%) patients developed cancers, which were found on subsequent screening mammograms. The area where the cancers developed in two (40%) of these five patients was marked (true-positive finding) by the computer in the preceding year. Because of CAD results, a 9.7% increase in recall rate from 14.4% (344 of 2,389) to 15.8% (378 of 2,389) occurred. Radiologists' recall rate of study patients prior to use of CAD was 31% higher than the average rate for nonstudy cases (10.3%) during the same time period at institution A. CONCLUSION: Performance of the CAD program had a very high sensitivity of 91% (95% CI: 74%, 100%).

Adult↗
PubMed1998

Calculating appropriate target cancer detection rates and expected interval cancer rates for the UK NHS Breast Screening Programme. Interval Cancer Working Group.

OBJECTIVES: To enable better monitoring of interim outcome measures in the NHS Breast Screening Programme by providing revised targets for cancer detection rates, and revised expected interval cancer rates. DESIGN AND SETTING: Expected detection rates of invasive cancers at prevalent screen are calculated, using estimates of the underlying England and Wales incidence rates and age specific prevalence incidence ratios from the Swedish Two County Study. Expected interval cancer rates are also derived from this study, and are used to calculate expected detection rates at rescreening. RESULTS: The expected invasive cancer detection rates at first screen for women aged 50-52 is 3.6 per 1000. The expected rate at rescreening for women aged 53-64 is 4.0 per 1000. Expected interval cancer rates for women screened from 1995/6 onwards are 0.45 per 1000, 0.65 per 1000, and 1.2-1.3 per 1000 for the periods within 0-<12, 12-<24, and 24-<36 months of screening. CONCLUSIONS: The target cancer detection rates and expected interval cancer rates for the NHS Breast Screening Programme have been revised in the light of more recent data. Monitoring of the extent to which the programme is meeting these revised targets will give a more accurate indication of the potential to meet the Health of the Nation target of a 25% reduction in breast cancer mortality by the year 2000.

Breast Neoplasms↗
PubMed2006

Prostate cancer detection with 3-T MRI: comparison of diffusion-weighted and T2-weighted imaging.

OBJECTIVE: To compare the clinical value of diffusion-weighted (DW) and T2-weighted (T2W) imaging in detecting prostate cancer using a 3-Tesla (3T) magnetic resonance (MR) system. MATERIALS AND METHODS: Thirty-seven patients with suspected prostate cancer underwent T2W and DW imaging at 3T using an 8-channel phased-array coil. These images and apparent diffusion coefficient (ADC) maps were read retrospectively and blindly. The results were compared with histopathologic findings, and receiver operating characteristic (ROC) analysis was used to compare the cancer detection performance of T2W and DW imaging. RESULTS: The areas under the ROC curves for DW imaging and T2W imaging were 0.89 and 0.82, respectively. The performance of DW imaging in prostate cancer detection was significantly better than that of T2W imaging (P=0.0371). CONCLUSION: With a 3T MR system, the performance of DW imaging in detecting prostate cancer was better than that of T2W imaging. DW imaging appears to be a robust and reliable method to examine the whole prostate within an acceptable scan time in clinical settings.

Adenocarcinoma↗
PubMed2006

Early gastric cancer and early colon cancer detected simultaneously by PET cancer screening incidentally.

We report a case of early gastric cancer and early colon cancer detected by positron emission tomography (PET) cancer screening. A 64-year-old male patient with an unremarkable past history except for hypertension and cerebrovascular disease underwent 18F-FDG PET for cancer screening. Images revealed increased uptake in the gastric antrum and sigmoid colon. Both areas appeared suspicious for neoplasm on subsequent fluoroscopy and endoscopy, and biopsies were positive for neoplasia at both sites. The gastric lesion was treated by distal gastrectomy and D2 lymphadenectomy and the colon cancer by endoscopic mucosal resection (EMR). Both surgical specimens were positive for cancer.

Colonic Neoplasms↗
PubMed1999

Expression of transitional cell-specific genes, uroplakin Ia and II, in bladder cancer: detection of circulating cancer cells in the peripheral blood of metastatic patients.

BACKGROUND: Uroplakins (UP), urothelium-specific transmembrane proteins, are present only in urothelia and may be good candidates as tumor markers specific for transitional cell carcinomas (TCC). We investigated the expression of UP-Ia and UP-II genes in the tissues and peripheral blood of patients with TCC. METHODS: We investigated UP-Ia and UP-II gene expression in tissues from 12 patients with TCC by reverse transcription-polymerase chain reaction (RT-PCR). HT1197, a TCC cell line, was used as an indicated cell line to assess a detection system for the UP-II gene-expressing cancer cells by nested RT-PCR. We also investigated UP-II gene expression in the peripheral blood of 12 other patients with TCC by nested RT-PCR. RESULTS: Prior to the investigation of UP-Ia and UP-II gene expression, a partial nucleotide sequence of human UP-II gene cDNA was determined to prepare the primers for RT-PCR. Uroplakin genes were expressed in both cancerous and non-cancerous urothelia taken from all patients examined by RT-PCR. The detection sensitivity of our assay showed that one cancer cell could be detected in 5 mL peripheral blood. UP-II gene-expression was detected in the peripheral blood from all three patients with metastatic TCC but not from the nine patients with non-metastatic TCC nor the three healthy volunteers. CONCLUSIONS: Uroplakins may be employed as tumor markers for transitional cell cancer, because they are highly conserved and well expressed, not only in non-cancerous cells but also in cancer cells. Furthermore, detection of UP-II gene expression in blood by nested RT-PCR may provide helpful information in the diagnosis and management of TCC.

Adult↗
PubMed2002

Prostate: high-frequency Doppler US imaging for cancer detection.

PURPOSE: To evaluate cancer detection with targeted biopsy of the prostate performed on the basis of high-frequency Doppler ultrasonographic (US) imaging findings versus cancer detection with a modified sextant biopsy approach with laterally directed cores. MATERIALS AND METHODS: Sixty-two patients were prospectively evaluated with gray-scale, color, and power Doppler transrectal US performed with patients in the lithotomy position. Gray-scale and Doppler findings within each sextant were rated on a five-point scale. Up to four targeted biopsy specimens were obtained from each patient on the basis of Doppler findings; this was followed by a modified sextant biopsy. Conditional logistic regression analysis was performed to compare the positive yields for targeted and sextant biopsy specimens. Clustered receiver operating characteristic analysis was performed to compare gray-scale, color, and power Doppler detection of cancer at sextant biopsy sites. RESULTS: Cancer was detected in 18 (29%) of 62 patients, including 11 patients in whom cancer was detected with both sextant and targeted biopsy, six in whom cancer was detected only with sextant biopsy, and one in whom cancer was detected only with targeted biopsy. The positive biopsy rate for targeted biopsy (24 [13%] of 185 cores) was slightly higher than that for sextant biopsy (36 [9.7%] of 372 cores; P =.1). The odds ratio for cancer detection with targeted versus sextant cores was 1.8 (95% CI: 0.9, 3.7). Receiver operating characteristic analysis demonstrated that overall identification of positive sextant biopsy sites was close to random chance for gray-scale (area under the curve, 0.53), color Doppler (area under the curve, 0.50), and power Doppler (area under the curve, 0.47) imaging. CONCLUSION: Targeted biopsy performed on the basis of high-frequency color or power Doppler findings will miss a substantial number of cancers detected with sextant biopsy.

Aged↗