• Korean Journal of Radiology
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• 제24권11호
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• pp.1102-1113
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• 2023

Objective: To elucidate the use of radiological studies, including nuclear medicine, and biopsy for the diagnosis and staging of prostate cancer (PCA) in clinical practice and understand the current status of PCA in Asian countries via an international survey. Materials and Methods: The Asian Prostate Imaging Working Group designed a survey questionnaire with four domains focused on prostate magnetic resonance imaging (MRI), other prostate imaging, prostate biopsy, and PCA backgrounds. The questionnaire was sent to 111 members of professional affiliations in Korea, Japan, Singapore, and Taiwan who were representatives of their working hospitals, and their responses were analyzed. Results: This survey had a response rate of 97.3% (108/111). The rates of using 3T scanners, antispasmodic agents, laxative drugs, and prostate imaging-reporting and data system reporting for prostate MRI were 21.6%-78.9%, 22.2%-84.2%, 2.3%-26.3%, and 59.5%-100%, respectively. Respondents reported using the highest b-values of 800-2000 sec/mm² and fields of view of 9-30 cm. The prostate MRI examinations per month ranged from 1 to 600, and they were most commonly indicated for biopsy-naïve patients suspected of PCA in Japan and Singapore and staging of proven PCA in Korea and Taiwan. The most commonly used radiotracers for prostate positron emission tomography are prostate-specific membrane antigen in Singapore and fluorodeoxyglucose in three other countries. The most common timing for prostate MRI was before biopsy (29.9%). Prostate-targeted biopsies were performed in 63.8% of hospitals, usually by MRI-ultrasound fusion approach. The most common presentation was localized PCA in all four countries, and it was usually treated with radical prostatectomy. Conclusion: This survey showed the diverse technical details and the availability of imaging and biopsy in the evaluation of PCA. This suggests the need for an educational program for Asian radiologists to promote standardized evidence-based imaging approaches for the diagnosis and staging of PCA.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3897-3901
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• 2013

Background: Optimal treatment for prostate cancer remains a challenge worldwide. Recently, T cell immunoglobulin mucin-3 (TIM-3) has been implicated in tumor biology but its contribution prostate cancer remains unclear. The aim of this study was to investigate the role of TIM-3 as a prognostic marker in patients with prostate cancer. Methods: TIM-3 protein expression was determined by immunohistochemistry and Western blotting in 137 prostate cancer tumor samples and paired adjacent benign tissue. We also performed cell proliferation assays using 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyl- 2H tetrazolium bromide (MTT) and cell invasion assays. The effects of small interfering RNA (siRNA)-mediated knockdown of TIM-3 (TIM-3 siRNA) in two human prostate cancer cell lines were also evaluated. Results: TIM-3 expression was higher in prostate cancer tissue than in the adjacent benign tissue (P<0.001). High TIM-3 expression was an independent predictor of both recurrence-free survival and progression-free survival. TIM-3 protein was expressed in both prostate cancer cell lines and knockdown suppressed their proliferation and invasion capacity. Conclusions: TIM-3 expression is associated with a poor prognosis in prostate cancer. Taken together, our resutlts indicate that TIM-3 is a potential prognostic marker in prostate cancer.

• 대한방사선기술학회지:방사선기술과학
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• 제41권4호
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• pp.313-319
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• 2018

The purpose of this study was to investigate the influence of metabolic syndrome (MS) on the lower urinary tract symptoms (LUTS), prostate specific antigen (PSA), and prostate volume in Korean men. We analyzed the data from 2654 men over the age of 40 who visited our health promotion center for regular health checkups. Of the total 2654 men, mean age, PSA level, International Prostate Symptom Score (IPSS), and prostate volume were 54.6 years, 1.21ng/ml, 6.2 points, and 27.8ml, respectively. All examinees were divided into MS group (46.5%, 1235 men) and non-MS group (53.5%, 1419). Age and prostate volume were significantly higher in the MS group. The patients were divided into three groups according to their ages: 40's, 50's, and over 60 years old. Prostate volume of the MS group in the younger age groups (40-49 years and 50-59 years) was significantly larger than that of the non-MS group. However, no difference was revealed in the age group of 60-69 years. No significant differences were found in the PSA level and LUTS between the MS and non-MS groups. In the multivariate regression analysis, central obesity was the strongest risk factor for the enlargement of prostate over 30ml among the metabolic components.

• Asian Pacific Journal of Cancer Prevention
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• 제15권20호
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• pp.8937-8939
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• 2014

The aim of this study is to determine results of high prostate specific antigen (PSA) or abnormal digital rectal examination driven prostate biopsies performed in our Department in men aged 75 or more and to show the characteristics of pathology results. The hospital records of the patients who had high PSA or abnormal digital rectal examination driven prostate biopsy in two common university based research hospitals have been reviewed retrospectively. Patients aged 75 years or older at the date of biopsy whose records provided pathology results and full medical history were evaluated for the study. A total of 103 patients were evaluated with a mean age of $79.4{\pm}3.4years$. More than half of the patients (55.1%) were in their seventh decade and the rest were in the eighth decade. Median PSA value was 15.0 (range 2.1-4500) ng/ml. In most of the biopsies (67%), PSA levels were lower than 20 ng/ml. In almost half of the patients (48%), digital rectal examination was abnormal. In 68.9% of the patients, there were at least one or more associated co-morbid diseases. Gleason scores were 7 or higher in 73%, and 8 or higher in 37% of the patients with prostate cancer. Four of the 70 (6%) patients had bone metastases. Castrations were applied to most of the patients with prostate adenocarcinoma (%79). High percentage of high grade (Gleason 7 or more) prostate adenocarcinoma in the elderly refutes the perception of prostate cancer in this age group as clinically insignificant. Therefore, it is to be kept in mind that prostate cancer in the elderly an be clinically significant and prostate biopsies are to be performed when necessary.

• Asian Pacific Journal of Cancer Prevention
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• 제14권10호
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• pp.6085-6088
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• 2013

Prostate specidic antigen (PSA) and digital rectal examination (DRE) are the known predictive factors for positive prostate biopsies differing according to the age, region and race. There have been only very limited studies about the impact of PSA on histological findings at prostate biopsy in Turkey. The aim of this study was to evaluate the impact of PSA and clinical stage on histologic findings of prostate biopsy in men older than 75 years of age as a first study in the Turkish population. A total of 1,645 consecutive prostate biopsies were included, with 194 men aged 75 or older. Cancer was identified in 104 patients (53.6%). Of the 104 positive biopsies, Gleason scores were less than 7 in 53 (49%) patients, 7 or greater in 51 (51%) patients. Positive prostate biopsies were significantly correlated with advanced age (p=0.0001), abnormal DRE (p=0.0001) and raised PSA (p=0.0001). The prostate volume was significantly correlated with advanced age especially in prostate cancer patients over 75 years, compared with those under 75 (p=0.0001). These results are useful for counseling men older than 75 years for prostate cancer detection. However, PCa screening decisions are currently based on urologist judgment and detection of latent asymptomatic disease is an important concern regarding costs, overdiagnosis, overtreatment and quality of life (QOL) for men aged 75 years and older. Healthy old patients with a long life expectancy need to be carefully evaluated for eligibility for PCa screening.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3385-3390
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• 2016

Background: Sequential use of circulating prostate cell (CPC) detection has been reported to potentially decrease the number of unnecessary prostate biopsies in men suspected of prostate cancer. In order to determine the real world effectiveness of the test, we present a prospective study of men referred to two hospitals from primary care physicians, one using CPC detection to determine the necessity of prostate biopsy the other not doing so. Materials and Methods: Men with a suspicion of prostate cancer because of elevated PSA >4.0ng/ml or abnormal DRE were referred to Hospitals A or B. In Hospital A all underwent 12 core TRUS biopsy, in Hospital B only men CPC (+), with mononuclear cells obtained by differential gel centrifugation identified using double immunomarking with anti-PSA and anti-P504S, were recommended to undergo TRUS biopsy. Biopsies were classifed as cancer or no-cancer. Diagnostic yields were calculated, including the number of posible biopsies that could be avoided and the number of clinically significant cancers that would be missed. Results: Totals of 649 men attended Hospital A, and 552 men attended Hospital B; there were no significant differences in age or serum PSA levels. In Hospital A, 228 (35.1%) men had prostate cancer detected, CPC detection had a sensitivity of 80.7%, a specificity of 88.6%, and a negative predictive value of 89.5%. Some 39/44 men CPC negative with a positive biopsy had low grade small volume tumors. In Hospital B, 316 (57.2%) underwent biopsy. There were no significant differences between populations in terms of CPC and biopsy results. The reduction in the number of biopsies was 40%. Conclusions: The use of sequential CPC testing in the real world gives a clear decision structure for patient management and can reduce the number of biopsies considerably.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5281-5286
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• 2013

Purpose: Prostate cancer caused by the abnormal disorderly growth of prostatic acinar cells is the most prevalent cancer of men in western countries. We aimed to screen out differentially expressed genes (DEGs) and explore small molecule drugs for prostate cancer. Materials and Methods: The GSE3824 gene expression profile of prostate cancer was downloaded from Gene Expression Omnibus database which including 21 normal samples and 18 prostate cancer cells. The DEGs were identified by Limma package in R language and gene ontology and pathway enrichment analyses were performed. In addition, potential regulatory microRNAs and the target sites of the transcription factors were screened out based on the molecular signature database. In addition, the DEGs were mapped to the connectivity map database to identify potential small molecule drugs. Results: A total of 6,588 genes were filtered as DEGs between normal and prostate cancer samples. Examples such as ITGB6, ITGB3, ITGAV and ITGA2 may induce prostate cancer through actions on the focal adhesion pathway. Furthermore, the transcription factor, SP1, and its target genes ARHGAP26 and USF1 were identified. The most significant microRNA, MIR-506, was screened and found to regulate genes including ITGB1 and ITGB3. Additionally, small molecules MS-275, 8-azaguanine and pyrvinium were discovered to have the potential to repair the disordered metabolic pathways, abd furthermore to remedy prostate cancer. Conclusions: The results of our analysis bear on the mechanism of prostate cancer and allow screening for small molecular drugs for this cancer. The findings have the potential for future use in the clinic for treatment of prostate cancer.

• 디지털콘텐츠학회 논문지
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• 제15권6호
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• pp.675-682
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• 2014

전립선은 남자에게만 있는 장기이다. 전립선의 질병을 진단하기 위하여 일반적으로 TRUS 영상이 사용되는데, 희미한 전립선 경계나 잡음, 좁은 그레이 레벨 분포 때문에, 전립선의 경계를 검출하는 것은 상당히 어려운 작업 중의 하나이다. 본 논문에서는 SVM을 사용하여 TRUS 영상에서 자동적으로 전립선 분할을 하는 방법을 제안한다. 이 방법은 전처리, 가버 특징 추출, 훈련, 전립선 분할 과정으로 진행된다. 전처리 과정에서 잡음 제거는 스틱 필터와 top-hat 변환이 적용된다. 회전 불변 텍스처 추출을 위하여 가버 필터 뱅크가 사용된다. 훈련과정에서 SVM은 전립선과 비전립선의 각 특징을 얻기 위해 사용되며, 마지막으로 전립선 경계가 추출된다. 여러 실험 결과로 제안 방법은 충분히 유효하고, 의사의 수동 추출 방법과 비교했을 때 10%미만의 경계 차이를 보였다.

• Urogenital Tract Infection
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• 제13권3호
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• pp.79-83
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• 2018

Purpose: The 5 alpha reductase inhibitor (5ARI) reduces the size of the prostate and alleviates lower urinary tract symptoms. After stopping 5ARI, the prostate quickly recovers to its pre-medication size. The purpose of this study was to investigate the factors affecting the restoration of prostate size after 5ARI discontinuation. Materials and Methods: Between March 2009 and May 2017, patients who visited an outpatient clinic and were diagnosed with benign prostatic hyperplasia were selected and start 5ARI medication. After 6 months of medication, the patients stopped medication for 1 year. Meanwhile, we measured the prostate volumes of patients 3 times (before and after medication, after discontinuation) and divide the patients into 3 groups (maintained, intermediate, and restored) with recovered prostate volume ratio. After classification, we investigated the relationship between the variable factors (age, serum prostate-specific antigen, initial volume, reduced volume after medication) between groups. Results: Among the 147 selected patients, the mean age and plasma PSA level were $61.6{\pm}7.9$ and $0.8{\pm}0.6$, respectively. The mean initial prostate volume was $32.3{\pm}4.2ml$, which reduced to $23.2{\pm}3.2ml$ after medication. After one year of discontinuation, the mean volume was $31.4{\pm}6.4ml$, with restoration to 101.5% of the reduced size. We noticed a tendency that patients with faster prostate volume recovery were generally older than those with slower recovery; however, this was not statistically significant. Other factors showed no relationship with prostate recovery. Conclusions: When using 5ARI in elderly patients, continuous treatment seems better than intermittent treatment. If discontinuation is needed, short term follow-up is recommended.

• Nuclear Medicine and Molecular Imaging
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• 제42권sup1호
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• pp.116-120
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• 2008

Prostate cancer is the second leading cause of cancer death of men in western countries and the death related to this disease in Korea is also getting increased. Although anatomic imaging tools such as transrectal US or MRI have been playing a great role in detection of primary prostate lesion, the evaluation of regional lymph node or distant organ metastasis using these modalities is not successful. $^{18}F-FDG-PET$ scan is emerging diagnostic tool for various malignancies. Considering the usual characteristics of prostate cancer such as slow growing and osteoblastic metastasis, the application of FDG PET scan to this disease might be limited. However, in advanced prostate cancer refractory to chemotherapy, FDG PET scan show strong FDG uptake and SUV changes in serial PET scan can be a good indicator of treatment response. Although FDG PET can be useful only in limited cases of prostate cancer, its indication can be widened in future owing to rapid technical improvement and accumulated experiences in this field.