Extent of High-Grade Prostatic Adenocarcinoma in Multiparametric Magnetic Resonance Imaging-Targeted Biopsy Enhances Prediction of Pathologic Stage
Multiparametric magnetic resonance imaging (mpMRI) of prostate with targeted biopsy has enhanced detection of high-grade prostatic adenocarcinoma (HG PCa). However, utility of amount of HG PCa (Gleason pattern 4/5) in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse out...
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| Veröffentlicht in: | Archives of pathology & laboratory medicine (1976) 2022-02, Vol.146 (2), p.201-204 |
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| creator | Paulson, Nathan Vollmer, Robin T Humphrey, Peter A Sprenkle, Preston C Onofrey, John Huber, Steffen Amirkhiz, Kamyar Levi, Angelique W |
| description | Multiparametric magnetic resonance imaging (mpMRI) of prostate with targeted biopsy has enhanced detection of high-grade prostatic adenocarcinoma (HG PCa). However, utility of amount of HG PCa (Gleason pattern 4/5) in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse outcomes on radical prostatectomy (RP) is unknown.
To examine the utility of amount of HG PCa in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse RP outcomes.
We performed a retrospective review of prostate biopsies that had corresponding RP, 1 or more mpMRI-targeted biopsy, and Grade Group 2 disease or higher. For the 169 cases identified, total millimeters of carcinoma and HG PCa and longest length HG PCa in a single core were recorded for 12-core biopsies and each set of mpMRI-targeted biopsies. For RP specimens, Gleason grade, extraprostatic extension, seminal vesicle involvement, and lymph node metastasis were recorded. The main outcome studied was prostate-confined disease at RP. A logistic regression model was used to test which pre-RP variables related to this outcome.
Univariate analysis showed significant associations with adverse RP outcomes in 5 of 8 quantifiable variables; longest millimeter HG PCa in a single 12-core biopsy, highest Grade Group in any core, and total millimeter HG in mpMRI-targeted biopsies showed no statistical association (P = .54, P = .13, and P = .55, respectively). In multivariate analysis, total millimeter carcinoma in all cores, highest Grade Group in any core, and longest millimeter HG PCa in a single mpMRI-targeted core provided additional predictive value (P < .001, P = .004, and P = .03, respectively).
Quantitation of HG PCa in mpMRI-targeted biopsies provides additional value over 12-core biopsies alone in predicting nonorgan confined prostate cancer at RP. Linear millimeters of HG PCa in mpMRI-targeted biopsies is a significant parameter associated with higher pathologic stage and could be of value in risk models. |
| doi_str_mv | 10.5858/arpa.2020-0568-OA |
| format | Article |
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To examine the utility of amount of HG PCa in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse RP outcomes.
We performed a retrospective review of prostate biopsies that had corresponding RP, 1 or more mpMRI-targeted biopsy, and Grade Group 2 disease or higher. For the 169 cases identified, total millimeters of carcinoma and HG PCa and longest length HG PCa in a single core were recorded for 12-core biopsies and each set of mpMRI-targeted biopsies. For RP specimens, Gleason grade, extraprostatic extension, seminal vesicle involvement, and lymph node metastasis were recorded. The main outcome studied was prostate-confined disease at RP. A logistic regression model was used to test which pre-RP variables related to this outcome.
Univariate analysis showed significant associations with adverse RP outcomes in 5 of 8 quantifiable variables; longest millimeter HG PCa in a single 12-core biopsy, highest Grade Group in any core, and total millimeter HG in mpMRI-targeted biopsies showed no statistical association (P = .54, P = .13, and P = .55, respectively). In multivariate analysis, total millimeter carcinoma in all cores, highest Grade Group in any core, and longest millimeter HG PCa in a single mpMRI-targeted core provided additional predictive value (P < .001, P = .004, and P = .03, respectively).
Quantitation of HG PCa in mpMRI-targeted biopsies provides additional value over 12-core biopsies alone in predicting nonorgan confined prostate cancer at RP. Linear millimeters of HG PCa in mpMRI-targeted biopsies is a significant parameter associated with higher pathologic stage and could be of value in risk models.</description><identifier>ISSN: 0003-9985</identifier><identifier>ISSN: 1543-2165</identifier><identifier>EISSN: 1543-2165</identifier><identifier>DOI: 10.5858/arpa.2020-0568-OA</identifier><identifier>PMID: 34015819</identifier><language>eng</language><publisher>United States: College of American Pathologists</publisher><subject>Adenocarcinoma ; Adenocarcinoma - diagnostic imaging ; Antigens ; Biopsy ; Cancer surgery ; Carcinoma ; Diagnosis ; Health surveillance ; Humans ; Image-Guided Biopsy - methods ; Lymphatic system ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Metastasis ; Methods ; Multiparametric Magnetic Resonance Imaging ; Multivariate analysis ; Neoplasm Grading ; Prostate ; Prostate cancer ; Prostatectomy ; Prostatic Neoplasms - pathology ; Tumor staging ; Urological surgery</subject><ispartof>Archives of pathology & laboratory medicine (1976), 2022-02, Vol.146 (2), p.201-204</ispartof><rights>COPYRIGHT 2022 College of American Pathologists</rights><rights>Copyright College of American Pathologists Feb 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c460t-de451039f1d7bae7c0e5736fcad38b9f615755108def1b1de2949c04d6e7c51d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34015819$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paulson, Nathan</creatorcontrib><creatorcontrib>Vollmer, Robin T</creatorcontrib><creatorcontrib>Humphrey, Peter A</creatorcontrib><creatorcontrib>Sprenkle, Preston C</creatorcontrib><creatorcontrib>Onofrey, John</creatorcontrib><creatorcontrib>Huber, Steffen</creatorcontrib><creatorcontrib>Amirkhiz, Kamyar</creatorcontrib><creatorcontrib>Levi, Angelique W</creatorcontrib><title>Extent of High-Grade Prostatic Adenocarcinoma in Multiparametric Magnetic Resonance Imaging-Targeted Biopsy Enhances Prediction of Pathologic Stage</title><title>Archives of pathology & laboratory medicine (1976)</title><addtitle>Arch Pathol Lab Med</addtitle><description>Multiparametric magnetic resonance imaging (mpMRI) of prostate with targeted biopsy has enhanced detection of high-grade prostatic adenocarcinoma (HG PCa). However, utility of amount of HG PCa (Gleason pattern 4/5) in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse outcomes on radical prostatectomy (RP) is unknown.
To examine the utility of amount of HG PCa in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse RP outcomes.
We performed a retrospective review of prostate biopsies that had corresponding RP, 1 or more mpMRI-targeted biopsy, and Grade Group 2 disease or higher. For the 169 cases identified, total millimeters of carcinoma and HG PCa and longest length HG PCa in a single core were recorded for 12-core biopsies and each set of mpMRI-targeted biopsies. For RP specimens, Gleason grade, extraprostatic extension, seminal vesicle involvement, and lymph node metastasis were recorded. The main outcome studied was prostate-confined disease at RP. A logistic regression model was used to test which pre-RP variables related to this outcome.
Univariate analysis showed significant associations with adverse RP outcomes in 5 of 8 quantifiable variables; longest millimeter HG PCa in a single 12-core biopsy, highest Grade Group in any core, and total millimeter HG in mpMRI-targeted biopsies showed no statistical association (P = .54, P = .13, and P = .55, respectively). In multivariate analysis, total millimeter carcinoma in all cores, highest Grade Group in any core, and longest millimeter HG PCa in a single mpMRI-targeted core provided additional predictive value (P < .001, P = .004, and P = .03, respectively).
Quantitation of HG PCa in mpMRI-targeted biopsies provides additional value over 12-core biopsies alone in predicting nonorgan confined prostate cancer at RP. Linear millimeters of HG PCa in mpMRI-targeted biopsies is a significant parameter associated with higher pathologic stage and could be of value in risk models.</description><subject>Adenocarcinoma</subject><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Antigens</subject><subject>Biopsy</subject><subject>Cancer surgery</subject><subject>Carcinoma</subject><subject>Diagnosis</subject><subject>Health surveillance</subject><subject>Humans</subject><subject>Image-Guided Biopsy - methods</subject><subject>Lymphatic system</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Metastasis</subject><subject>Methods</subject><subject>Multiparametric Magnetic Resonance Imaging</subject><subject>Multivariate analysis</subject><subject>Neoplasm Grading</subject><subject>Prostate</subject><subject>Prostate cancer</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Tumor staging</subject><subject>Urological surgery</subject><issn>0003-9985</issn><issn>1543-2165</issn><issn>1543-2165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptkttq3DAQhk1pabZpH6A3xVAoufFWB8uHy03YHCBhQ5tei1lp7FWwpa0kQ_McfeHKJD2kLLoQ0nz_r2H0Z9l7SpaiEc1n8HtYMsJIQUTVFJvVi2xBRckLRivxMlsQQnjRto04yt6EcJ-OLWP0dXbES0JFQ9tF9nP9I6KNuevyS9PvigsPGvNb70KEaFS-0midAq-MdSPkxuY30xDNHjyMGH0ibqC3OKNfMDgLVmF-NUJvbF_cge8xos5PjduHh3xtd3M9JH_URkXj7PzwLcSdG1yfPL5G6PFt9qqDIeC7p_04-3a-vju7LK43F1dnq-tClRWJhcZSUMLbjup6C1grgqLmVadA82bbdhUVtUhEo7GjW6qRtWWrSKmrxAqq-XF28ui79-77hCHK0QSFwwAW3RQkE5wyykldJ_Tjf-i9m7xN3UlWJV9O25r-pXoYUBrbuehBzaZyVbUla3jNWKKKA1SPFj0MzmJn0vUzfnmAT0vjaNRBwad_BDuEIe6CG6Z53uE5SB9Blf47eOzk3psR_IOkRM4Jk3PC5JwwOSdMblZJ8-FpEtN2RP1H8TtS_BdBV8wq</recordid><startdate>20220201</startdate><enddate>20220201</enddate><creator>Paulson, Nathan</creator><creator>Vollmer, Robin T</creator><creator>Humphrey, Peter A</creator><creator>Sprenkle, Preston C</creator><creator>Onofrey, John</creator><creator>Huber, Steffen</creator><creator>Amirkhiz, Kamyar</creator><creator>Levi, Angelique W</creator><general>College of American Pathologists</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20220201</creationdate><title>Extent of High-Grade Prostatic Adenocarcinoma in Multiparametric Magnetic Resonance Imaging-Targeted Biopsy Enhances Prediction of Pathologic Stage</title><author>Paulson, Nathan ; Vollmer, Robin T ; Humphrey, Peter A ; Sprenkle, Preston C ; Onofrey, John ; Huber, Steffen ; Amirkhiz, Kamyar ; Levi, Angelique W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c460t-de451039f1d7bae7c0e5736fcad38b9f615755108def1b1de2949c04d6e7c51d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adenocarcinoma</topic><topic>Adenocarcinoma - diagnostic imaging</topic><topic>Antigens</topic><topic>Biopsy</topic><topic>Cancer surgery</topic><topic>Carcinoma</topic><topic>Diagnosis</topic><topic>Health surveillance</topic><topic>Humans</topic><topic>Image-Guided Biopsy - methods</topic><topic>Lymphatic system</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Metastasis</topic><topic>Methods</topic><topic>Multiparametric Magnetic Resonance Imaging</topic><topic>Multivariate analysis</topic><topic>Neoplasm Grading</topic><topic>Prostate</topic><topic>Prostate cancer</topic><topic>Prostatectomy</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Tumor staging</topic><topic>Urological surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paulson, Nathan</creatorcontrib><creatorcontrib>Vollmer, Robin T</creatorcontrib><creatorcontrib>Humphrey, Peter A</creatorcontrib><creatorcontrib>Sprenkle, Preston C</creatorcontrib><creatorcontrib>Onofrey, John</creatorcontrib><creatorcontrib>Huber, Steffen</creatorcontrib><creatorcontrib>Amirkhiz, Kamyar</creatorcontrib><creatorcontrib>Levi, Angelique W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database (ProQuest)</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of pathology & laboratory medicine (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paulson, Nathan</au><au>Vollmer, Robin T</au><au>Humphrey, Peter A</au><au>Sprenkle, Preston C</au><au>Onofrey, John</au><au>Huber, Steffen</au><au>Amirkhiz, Kamyar</au><au>Levi, Angelique W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extent of High-Grade Prostatic Adenocarcinoma in Multiparametric Magnetic Resonance Imaging-Targeted Biopsy Enhances Prediction of Pathologic Stage</atitle><jtitle>Archives of pathology & laboratory medicine (1976)</jtitle><addtitle>Arch Pathol Lab Med</addtitle><date>2022-02-01</date><risdate>2022</risdate><volume>146</volume><issue>2</issue><spage>201</spage><epage>204</epage><pages>201-204</pages><issn>0003-9985</issn><issn>1543-2165</issn><eissn>1543-2165</eissn><abstract>Multiparametric magnetic resonance imaging (mpMRI) of prostate with targeted biopsy has enhanced detection of high-grade prostatic adenocarcinoma (HG PCa). However, utility of amount of HG PCa (Gleason pattern 4/5) in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse outcomes on radical prostatectomy (RP) is unknown.
To examine the utility of amount of HG PCa in mpMRI-targeted biopsies versus standard 12-core biopsies in predicting adverse RP outcomes.
We performed a retrospective review of prostate biopsies that had corresponding RP, 1 or more mpMRI-targeted biopsy, and Grade Group 2 disease or higher. For the 169 cases identified, total millimeters of carcinoma and HG PCa and longest length HG PCa in a single core were recorded for 12-core biopsies and each set of mpMRI-targeted biopsies. For RP specimens, Gleason grade, extraprostatic extension, seminal vesicle involvement, and lymph node metastasis were recorded. The main outcome studied was prostate-confined disease at RP. A logistic regression model was used to test which pre-RP variables related to this outcome.
Univariate analysis showed significant associations with adverse RP outcomes in 5 of 8 quantifiable variables; longest millimeter HG PCa in a single 12-core biopsy, highest Grade Group in any core, and total millimeter HG in mpMRI-targeted biopsies showed no statistical association (P = .54, P = .13, and P = .55, respectively). In multivariate analysis, total millimeter carcinoma in all cores, highest Grade Group in any core, and longest millimeter HG PCa in a single mpMRI-targeted core provided additional predictive value (P < .001, P = .004, and P = .03, respectively).
Quantitation of HG PCa in mpMRI-targeted biopsies provides additional value over 12-core biopsies alone in predicting nonorgan confined prostate cancer at RP. Linear millimeters of HG PCa in mpMRI-targeted biopsies is a significant parameter associated with higher pathologic stage and could be of value in risk models.</abstract><cop>United States</cop><pub>College of American Pathologists</pub><pmid>34015819</pmid><doi>10.5858/arpa.2020-0568-OA</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Archives of pathology & laboratory medicine (1976), 2022-02, Vol.146 (2), p.201-204 |
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| source | MEDLINE; Allen Press Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adenocarcinoma Adenocarcinoma - diagnostic imaging Antigens Biopsy Cancer surgery Carcinoma Diagnosis Health surveillance Humans Image-Guided Biopsy - methods Lymphatic system Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Metastasis Methods Multiparametric Magnetic Resonance Imaging Multivariate analysis Neoplasm Grading Prostate Prostate cancer Prostatectomy Prostatic Neoplasms - pathology Tumor staging Urological surgery |
| title | Extent of High-Grade Prostatic Adenocarcinoma in Multiparametric Magnetic Resonance Imaging-Targeted Biopsy Enhances Prediction of Pathologic Stage |
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