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Outcome of simultaneous thulium laser enucleation of bladder tumor and prostate in patients with non-muscle invasive bladder tumor and benign prostatic hyperplasia: a matched-pair comparison with a long-term follow-up
摘要： Objective To access the surgical and oncological outcomes of simultaneous thulium laser enucleation of bladder tumor (ThuLEBT) and thulium laser enucleation of prostate (ThuLEP) in patients with non-muscle invasive bladder tumor (NMIBC) and benign prostatic hyperplasia (BPH). Patients and methods Between June 2009 and June 2017, 118 men with NMIBC who underwent simultaneous ThuLEBT and ThuLEP and fulfilled the inclusion criteria were matched with 118 patients who received ThuLEBT alone. Clinico-pathological parameters, surgical outcome data and oncological outcomes were retrospectively analyzed and compared. Results The patients who underwent simultaneous ThuLEBT and ThuLEP experienced a longer length of operation time (70.4 vs. 25.5 min; p < 0.001), but there were no statistically significant differences in catheterization period, hospital stay and complication between the two groups. At a mean follow-up of 58.7 and 55.8 months in ThuLEBT/ThuLEP group and ThuLEBT group, no significant differences in overall recurrence rates, progression rates, recurrence in the bladder neck/prostatic fossa and mean elapsed time to recurrence were detected. The 5-year recurrence-free probability was 73.2% for ThuLEBT/ThuLEP and 69.2% for ThuLEBT (p = 0.361). Conclusions Our results indicate that simultaneous ThuLEBT and ThuLEP can be safely performed without increasing the surgical risk and the risk of tumor recurrence and progression in patients with NMIBC and BPH, and it may be preferred alternative for select patients.
关键词： Bladder tumor,Tumor recurrence,Benign prostatic hyperplasia,Laser therapy,Thulium laser enucleation of bladder tumor,Thulium laser enucleation of prostate
更新于2025-09-23 15:21:01
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Discovery of [ <sup>18</sup> F]PSMA-7, a novel PET-probe for the detection of small PSMA positive lesions
摘要： Prostate specific membrane antigen (PSMA) expressed by the vast majority of prostate cancers (PCa) is a promising target for PCa imaging. The application of PSMA specific 18F-labeled PET probes like 18F-DCFPyL and 18F-PSMA-1007 considerably improved the accuracy of PCa tumor detection. However, there remains a need for further improvements regarding sensitivity and specificity. The aim of this study was the development of highly selective and specific PSMA probes with enhanced imaging properties, in comparison with 18F-DCFPyL, 18F-PSMA-1007 and 68Ga-PSMA-11. Methods: Eight novel 18F-labeled PSMA ligands were prepared. Their cellular uptake in PSMA+ LNCaP C4-2 and PSMA– PC-3 cells was compared to that of 18F-DCFPyL. The most promising candidates were additionally evaluated by μPET in healthy rats using PSMA+ peripheral ganglia as a model for small PCa lesions. PET images of the ligand with the best outcome, 18F-JK-PSMA-7, were compared to those of 18F-DCFPyL, 18F-PSMA-1007 and 68Ga-PSMA-11 with respect to key image quality parameters for the time frame 60-120 min. Results: Compared to 18F-DCFPyL, 18F-JK-PSMA-7 demonstrated increased PSMA specific cellular uptake. While target-to-background ratios of 18F-DCFPyL and 18F-PSMA-1007 were comparable, this parameter was higher for 18F-JK-PSMA-7 and lower for 68Ga-PSMA-11. Image acutance was significantly higher for 18F-JK-PSMA-7 and 18F-PSMA-1007 compared to 18F-DCFPyL and 68Ga-PSMA-11. Image resolution was similar for all four tracers. 18F-PSMA-1007 demonstrated significantly higher blood protein binding and bone uptake than the other tracers. Conclusion: 18F-JK-PSMA-7 is a promising candidate for high quality visualization of small PSMA-positive lesions. Excellent preclinical imaging properties justify further preclinical and clinical studies of this tracer.
关键词： Prostate carcinoma,PSMA,preclinical model,radiofluorination,positron emission tomography,imaging
更新于2025-09-23 15:21:01
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Holmium laser enucleation of the prostate for very large benign prostatic hyperplasia (a?￥a??200??cc)
摘要： Purpose Patients presenting with prostate gland sizes greater than 200?cc pose a unique surgical challenge to both patients and surgeons. The objective of this study is to critically assess the efficacy and risks associated with performing holmium laser enucleation of the prostate (HoLEP) on glands ≥ 200?cc. Materials and methods Using a prospective maintained database, all consecutive benign prostatic hyperplasia (BPH) patients with gland size ≥ 200?cc who underwent HoLEP were included. We reported patient preoperative, intraoperative, postoperative outcomes and complications. Subgroup analysis of outcomes was stratified by gland sizes 200–299?cc and ≥ 300?cc. Univariate analysis using Kruskal–Wallis and Fisher exact test was performed to compare the two groups. Results There were 88 patients with a mean preoperative gland size of 255.9?cc (200–770?cc). Mean operative (171 vs 182?min) and enucleation time (77 vs 83?min) were not different between the two subgroups (200–299?cc vs ≥ 300?cc). Enucleation efficiency was greater for glands ≥ 300?cc (2.6?cc/min vs 2.0?cc/min, p = 0.04). Morcellation time was longer in the ≥ 300?cc group (74.5?min vs 46.8?min, p = 0.021). Mean length of stay was 1.8 ± 1.2?days and catheter duration was 2.6 ± 2.7?days. 1 (1.1%) patient required retreatment of BPH at last follow-up. The main limitation of this study is the retrospective data analysis. Conclusions Holmium laser enucleation for prostate glands volume > 200?cc is feasible with minimal morbidity. These data further reinforce the size independence success of this procedure for BPH.
关键词： Transurethral resection of prostate,Laser,Benign prostate hyperplasia,Holmium,Prostate,Holmium laser enucleation of the prostate,Lower urinary tract symptoms
更新于2025-09-23 15:19:57
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GREEN LIGHT PHOTOSELECTIVE VAPORIZATION OF THE PROSTATE: ONE LASER FOR DIFFERENT PROSTATE SIZES
摘要： INTRODUCTION GreenLight laser vaporization of the prostate (PVP) is a safe and effective procedure for Benign Prostatic Hyperplasia. Long term results and advantages of PVP in patients with large and symptomatic prostate are still under evaluation. MATERIALS AND METHODS In a multicenter experience, patients who underwent standard or anatomical PVP were retrospectively reviewed. Patients with follow-up >12 months were divided into two groups based on prostate volume (<100cc vs ≥100cc). Pre- and peri-operative data as well as post-operative results and complications were recorded after 3, 6, 12 months and then annually. RESULTS 1031 patients were eligible, 916 of these had a prostate volume of <100 cc and 115 ≥100 cc. Median follow-up period was 25.0 months (IQR 16.5-35.0) and 16.0 months (IQR 12.0-24.0) in ≥100 and <100 groups, respectively. No difference was found in terms of catheterization time, post-operative stay and post-operative acute urine retention. Patients with prostate ≥100 required longer operative time (75 versus 55 minutes), lasing time (41.7 versus 24.9 minutes), and higher energy used but lower energy density. Patients with prostate ≥100 had a higher incidence of early (50.4 versus 35.7%) and late complications (21.7 versus 12.8%) and early urge/incontinence symptoms (40.9 versus 29.3%). No statistically significant differences were found for the Qmax and IPSS results between the two groups. The re-intervention rate in ≥100 group was 3.5% versus 2.3% in <100. CONCLUSIONS In the midterm follow-up, Greenlight PVP guarantees the same results in different prostate volumes groups. Early and late complications are more frequent in large prostates.
关键词： complications,photoselective vaporization of the prostate,prostate volume,benign prostatic hyperplasia,GreenLight laser
更新于2025-09-23 15:19:57
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Modular medical imaging agents based on azidea??alkyne Huisgen cycloadditions: Synthesis and prea??clinical evaluation of 18Fa??labeled PSMAa??tracers for prostate cancer imaging.
摘要： The seminal contribution of Rolf Huisgen to develop the [3+2]-cycloaddition of 1,3-dipolar compounds, its azide-alkyne variant has established itself as the key step in numerous organic syntheses and bioorthogonal processes in materials science and chemical biology. In the present study, the copper(I)-catalyzed azide-alkyne cycloaddition was applied for the development of a modular molecular platform for medical imaging of the prostate specific membrane antigen (PSMA), using positron emission tomography. This process is shown from molecular design, through synthesis automation and in vitro studies, all the way to preclinical in vivo evaluation of fluorine-18– labeled PSMA-targeting ‘F-PSMA-MIC’ radiotracers (t? = 109.7 min). Preclinical data indicate that the modular PSMA-scaffold has similar binding affinity and imaging properties to the clinically used [68Ga]PSMA-11. Furthermore, we demonstrated that targeting the arene-binding in PSMA, facilitated through the [3+2]-cycloaddition, can improve binding affinity, which was rationalized by molecular modeling. The here presented PSMA-binding scaffold potentially facilitates easy coupling to other medical imaging moieties, enabling future developments of new modular imaging agents.
关键词： prostate specific membrane antigen,positron emission tomography,fluorine-18,azide-alkyne Huisgen cycloaddition,modular imaging agents
更新于2025-09-23 15:19:57
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Metal-labeled Aptamers as Novel nanoprobes for Imaging Mass Cytometry Analysis
摘要： Imaging mass cytometry (IMC) is an emerging imaging technology that exploits the multiplexed analysis capabilities of the CyTOF mass cytometer to make spatially resolved measurements for tissue sections. In a comprehensive view of tissue composition and marker distribution, recent developments of IMC require highly sensitive, multiplexed assays. Approaching the sensitivity of the IMC technique, we designed a novel type of biocompatible metal-labeled aptamer nanoprobe (MAP), named 167Er-A10-3.2. The small molecular probe was synthesized by conjugating 167Er-polymeric pentetic acid (167Er-DTPA) with an RNA aptamer A10-3.2. For demonstration, 167Er-A10-3.2 was applied for observing protein spatial distribution on prostatic epithelium cell of paraffin embedded Prostatic adenocarcinoma (PaC) tissue sections by IMC technology. The 167Er-A10-3.2 capitalizes on the ability of aptamer to specifically bind target cancer cells, as well as the small size of 167Er-A10-3.2 can accommodate multiple aptamer binding antigen labeled at high density. The detection signal of 167Er-A10-3.2 probe was 3-fold higher than that of PSMA antibody probe for a targeted cell under lower temperature epitope retrieval (37°C) of PaC tissue. Furthermore, we successfully demonstrated the simultaneously staining ability of aptamer probes in IMC analysis. The successful imaging acquisition using aptamers probes in IMC technology may offer opportunity for the diagnosis of malignancies in the future.
关键词： imaging mass cytometry,prostate specific membrane antigen,molecular probe,metal labeled aptamer
更新于2025-09-23 15:19:57
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Optimising patient outcomes with photoselective vaporization of the prostate (PVP): a review
摘要： Benign prostatic hyperplasia (BPH) is a common pathology causing lower urinary tract symptoms (LUTS) and may significantly impact quality of life. While transurethral resection of the prostate (TURP) remains the gold standard treatment, there are many evolving technologies that are gaining popularity. Photoselective vaporization of the prostate (PVP) is one such therapy which has been shown to be non-inferior to TURP. We aimed to review the literature and discuss factors to optimise patient outcomes in the setting of PVP for BPH. A comprehensive search of the electronic databases, including MEDLINE, Embase, Web of Science and The Cochrane Library was performed on articles published after the year 2000. After exclusion, a total of 38 papers were included for review. The evolution of higher powered device has enabled men with larger prostates and those on oral anticoagulation to undergo safely and successfully PVP. Despite continued oral anticoagulation in patients undergoing PVP, the risk of bleeding may be minimised with 5-Alpha Reductase Inhibitor (5-ARI) therapy however further studies are required. Pre-treatment with 5-ARI’s does not hinder the procedure however more studies are required to demonstrate a reliable benefit. Current data suggests that success and complication rate is largely influenced by the experience of the operator. Post-operative erectile dysfunction is reported in patients with previously normal function following PVP, however those with a degree of erectile dysfunction pre-operatively may see improvement with alleviation of LUTS.
关键词： sexual function,outcomes,urinary function,Benign prostatic hyperplasia (BPH),prostate,photoselective vaporization of the prostate (PVP)
更新于2025-09-19 17:15:36
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Improved repeatability of dynamic contrast-enhanced MRI using the complex MRI signal to derive arterial input functions: a test-retest study in prostate cancer patients
摘要： Purpose: The arterial input function (AIF) is a major source of uncertainty in tracer kinetic (TK) analysis of dynamic contrast‐enhanced (DCE)‐MRI data. The aim of this study was to investigate the repeatability of AIFs extracted from the complex signal and of the resulting TK parameters in prostate cancer patients. Methods: Twenty‐two patients with biopsy‐proven prostate cancer underwent a 3T MRI exam twice. DCE‐MRI data were acquired with a 3D spoiled gradient echo sequence. AIFs were extracted from the magnitude of the signal (AIFMAGN), phase (AIFPHASE), and complex signal (AIFCOMPLEX). The Tofts model was applied to extract Ktrans, kep and ve. Repeatability of AIF curve characteristics and TK parameters was assessed with the within‐subject coefficient of variation (wCV). Results: The wCV for peak height and full width at half maximum for AIFCOMPLEX (7% and 8%) indicated an improved repeatability compared to AIFMAGN (12% and 12%) and AIFPHASE (12% and 7%). This translated in lower wCV values for Ktrans (11%) with AIFCOMPLEX in comparison to AIFMAGN (24%) and AIFPHASE (15%). For kep, the wCV was 16% with AIFMAGN, 13% with AIFPHASE, and 13% with AIFCOMPLEX. Conclusion: Repeatability of AIFPHASE and AIFCOMPLEX is higher than for AIFMAGN, resulting in a better repeatability of TK parameters. Thus, use of either AIFPHASE or AIFCOMPLEX improves the robustness of quantitative analysis of DCE‐MRI in prostate cancer.
关键词： arterial input function,dynamic contrast‐enhanced MRI,repeatability,prostate cancer,tracer kinetic analysis,complex signal
更新于2025-09-19 17:15:36
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Imaging of Prostate-Specific Membrane Antigen with Small-Molecule PET Radiotracers: From the Bench to Advanced Clinical Applications
摘要： In recent years, small-molecule inhibitors of prostate-specific membrane antigen (PSMA) labeled with radionuclides that allow for positron emission tomography (PET) imaging have been extensively studied in many clinical contexts in men with prostate cancer (PCa). The high sensitivity and specificity of these agents for identifying sites of PCa has quickly led to their widespread adoption as a de facto clinical standard of care throughout much of the world. PSMA-targeted PET radiotracers have been particularly well-studied in preoperatively staging men with high-risk PCa, evaluating biochemical recurrence following definitive therapy, and guiding metastasis-directed therapy in patients suspected of having oligorecurrent/oligometastatic disease. Furthermore, the expression of PSMA on the tumor neovasculature of many nonprostate malignancies has enabled a burgeoning subfield concentrated on delineating the potential utility of PSMA-targeted PET agents for imaging other cancers. In this review, we highlight the preclinical development of key small molecules that are now being clinically utilized for PCa imaging, discuss the roles of PSMA-targeted agents in guiding patient management, and consider the role these compounds may play in imaging nonprostate cancers.
关键词： NAALADase,renal cell carcinoma,prostate cancer,glutamate carboxypeptidase II,tumor neovasculature
更新于2025-09-19 17:15:36
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CdTe@SiO2 signal reporters-based fluorescent immunosensor for quantitative detection of prostate specific antigen
摘要： In this paper, an immunosensor using CdTe@SiO2 core-shell nanoparticles as labels was constructed for highly sensitive detection of prostate-specific antigen (PSA). In this approach, CdTe@SiO2 core-shell nanoparticles were synthesized using the sol-gel method. The additional Cd ions and sulfur source in SiO2 shell can greatly enhance the fluorescence intensity of CdTe nanocrystals. The reason is the formation of CdS-like cluster in SiO2 shell, which reduced the quantum size effect. The obtained CdTe@SiO2 nanoparticles also exhibited excellent biocompatibility, which was ideal for applying in biomarker detection. Furthermore, PSA capture antibodies functionalized magnetic Fe3O4 nanoparticles (Fe3O4-Ab1) were utilized in the proposed immunosensor to capture and enrich the PSA. The captured PSA was then immuno-recognized by CdTe@SiO2 labeled with PSA detection antibodies (CdTe@SiO2-Ab2) by forming the sandwich complex Fe3O4-Ab1/PSA/Ab2-CdTe@SiO2. The construction of this immunosensor was confirmed by fluorescence spectroscopy. The proposed immunosensor showed a good linear relationship between the fluorescent intensity and the target PSA concentration ranging from 0.01 to 5 ng/mL, and a detection limit as low as 0.003 ng/mL was achieved. The sensor also exhibited good specificity to PSA. This highly sensitive and specific immunosensor has great potential to be used in other biological detection.
关键词： Quantum Dots,Core-shell,Prostate Specific Antigen,Immunosensor
更新于2025-09-19 17:15:36