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Learning curve for magnetic resonance imaging/ultrasound fusion prostate biopsy in detecting prostate cancer using cumulative sum analysis

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Current Urology 2023年第3期17卷 159-164页

作者： Linhan Xu Nancy Yating Ye Adrianna Lee Jasleen Chopra michael naslund Jade Wong-You-Cheong Amelia Wnorowski Mohummad Minhaj Siddiqui University of Maryland School of Medicine BaltimoreMDUSA Division of Urology Department of General SurgeryKaiser Permanente Los Angeles Medical CenterLos AngelesCAUSA Department of Diagnostic Radiology University of Maryland School of MedicineBaltimoreMDUSA Division of Urology Department of SurgeryUniversity of Maryland School of MedicineUniversity of Maryland Medical CenterBaltimoreMDUSA

Background:Targeted magnetic resonance(MR)with ultrasound(US)fusion-guided biopsy has been shown to improve detection of prostate *** implementation of this approach requires integration of skills from radiologists and *** methods for assessment of learning curves,such as cumulative sum(CUSUM)analysis,may be helpful in identifying the presence and duration of a learning *** aim of this study is to determine the learning curve for MR/US fusion-guided biopsy in detecting clinically significant prostate cancer using CUSUM *** and methods:Retrospective analysis was performed in this institutional review board-approved *** urologists implemented an MR/US fusion-guided prostate biopsy program between March 2015 and September *** primary outcome measure was cancer detection rate(CDR)stratified by Prostate Imaging Reporting and Data System(PI-RADS)scores assigned on the MR *** sum analysis quantified actual cancer detection versus a predetermined target satisfactory CDR of MR/US fusion biopsies in a sequential case-by-case *** this analysis,satisfactory performance was defined as>80%CDR in patients with Pl-RADS 5,>50%in PI-RADS 4,and<20%in Pl-RADS ***:Complete data were available for MR/US fusion-guided biopsies performed on 107 *** CUSUM learning curve analysis demonstrated intermittent underperformance until approximately 50 *** this inflection point,there was consistently good performance,evidence that no further learning curve was being ***:At a new center implementing MR/US fusion-guided prostate biopsy,the learning curve was approximately 50 cases before a consistently high performance for prostate cancer detection.

关键词： Cumulative sum analysis Learning curve Magnetic resonance/ultrasound fusion biopsy Prostate cancer

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Validation of an MRI-based prostate cancer prebiopsy Gleason score predictive nomogram

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Current Urology 2022年第1期16卷 38-43页

作者： Adrianna Jiaying Lee Amelia Wnorowski Nancy Ye Linhan Xu michael naslund Bradford J.Wood Maria J.Merino Baris Turkbey Peter L.Choyke Peter A.Pinto M.Minhaj Siddiqui University of Maryland BaltimoreMDUSA Baltimore VA Medical Center BaltimoreMDUSA Molecular Imaging Program National Cancer InstituteNational Institutes of HealthBethesdaMDUSA Center for Interventional Oncology National Cancer Institute&Clinical CenterNational Institutes of HealthBethesdaMDUSA Urologic Oncology Branch National Cancer InstituteNational Institutes of HealthBethesdaMDUSA

Background:Gleason score grading is a cornerstone of risk stratification and management of patients with prostate cancer(PCa).In this work,we derive and validate a nomogram that uses prostate multiparametric magnetic resonance imaging(MP-MRI)and clinical patient characteristics to predict biopsy Gleason scores(bGS).Materials and methods:A predictive nomogram was derived from 143 men who underwent MP-MRI prior to any prostate biopsy and then validated on an independent cohort of 235 men from a different institution who underwent MP-MRI for PCa *** positive lesions were defined as lesions positive on T2W and DWI sequences on *** specific antigen(PSA)density,number of screen positive lesions,and MRI suspicion were associated with PCa Gleason score on biopsy and were used to generate a predictive *** independent cohort was tested on the nomogram and the most likely bGS was ***:The mean PSA in the validation cohort was 9.25ng/mL versus 6.8ng/mL in the original cohort(p=0.001).The distribution of Gleason scores between the 2 cohorts were not significantly different(p=0.7).In the original cohort of men,the most probable nomogram generated Gleason score agreed with actual pathologic bGS findings in 61%of the *** the validation cohort,the most likely nomogram predicted bGS agreed with actual pathologic bGS 51%of the *** nomogram correctly identified any PCa versus non-PCa 63%of the time and clinically significant(Gleason score≥7)PCa 69%of the *** negative predictive value for clinically significant PCa using this prebiopsy nomogram was 74%in the validation ***:A preintervention nomogram based on PSA and MRI findings can help narrow down the likely pathologic finding on *** of the nomogram demonstrated a significant ability to correctly identify the most likely *** feasibility study demonstrates the potential of a prebiopsy prediction of bGS and based on the high negative predictive value,i

关键词： Multiparametric magnetic resonance imaging Nomogram Prostate cancer

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Bone blood flow is influenced by muscle contractions

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Journal of Biomedical Science and Engineering 2011年第7期4卷 490-496页

作者： Jan Erik naslund Sofie naslund Erik Lundeberg Lars-Goran Lindberg Irene Lund Department of Physiology and Pharmacology Karolinska InstitutetStockholmSweden Gavle Hospital GavleSweden Department of Biomedical Engineering Linkoping UniversityLinkopingSweden

Forces acting on the skeleton could be divided into those originating from gravitational loading and those originating from muscle loading. Flat bones in a non-weight-baring segment of the skeleton probably experience forces mostly generated by muscle contractions. One purpose of muscle contractions is to generate blood flow within skeletal tissues. The present study aimed to investigate the pulsatile patellar bone blood flow after low and high intensity leg extension exercises. Forty-two healthy individuals volunteered for the study. Dynamic isotonic one leg extension/flexion exercises were performed in a leg extension machine. Randomly, the exercises were performed with the left or right leg with either 10 repetition maximum (10 RM) continuously without any resting periods (high intensity muscle work), or 20 RM with a 2 second rest between contractions (low intensity muscle work). The work load, expressed in kilograms totally lifted, was identical in both legs. The pulsatile patellar blood flow was recorded continuously using a photoplethysmographic technique. Blood pressure was measured continuously during muscle work by a non-invasive method (Finapress). The patellar pulsatile bone blood flow increased significantly more after high intensity muscle work (61%) compared to the same work load performed using a lower intensity (22%), p = 0.000073. Systolic blood pressure changed equally during and after both interventions. Post-exercise bone hyperaemia appears to be correlated to the intensity of muscle contractions in the muscle compartment attached to the bone.

关键词： Bone Blood Flow Blood Pressure Photoplethysmography

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Bone and Soft Tissue Blood Flow during Normobaric and Hyperbaric Oxygen Breathing in Healthy Divers

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Journal of Biomedical Science and Engineering 2014年第12期7卷 973-981页

作者： Agneta C.Larsson Johan Uusijarvi Jan E.naslund Iréne Lund Peter Lindholm Department of Physiology and Pharmacology Karolinska InstituteStockholmSweden Department of Anaesthesia&Intensive Care Division of Hyperbaric MedicineKarolinska HospitalStockholmSweden Department of Radiology Karolinska HospitalStockholmSweden

Purpose: The study aimed to investigate, using a photoplethysmographic (PPG) technique, how pulsatile blood flow within the patellar bone and skin over the patella reacts to normobaric (NBO) and hyperbaric oxygen breathing (HBO). Methods: Eleven healthy volunteers, breathed air or oxygen. Subjects were blinded to breathing gas. A range of partial pressures of oxygen were administered in 10 minute intervals: 21 kPa, 101 kPa (NBO), 21 kPa, (compression to 280 kPa), 59 kPa, 280 kPa (HBO), 59 kPa, (decompression), and 21 kPa. Changes were measured continuously for each individual. Results: Hyperoxia decreased pulsatile patellar blood flow ~32 resp. 38% and skin blood flow ~36 resp. 42% during the first 2 - 3 minutes of NBO resp. HBO. This decrease was normalized within 5 minutes after exposure. The results were similar when switching from air to NBO (101 kPa) and from air at pressure (59 kPa) to HBO (280 kPa). Conclusions: The study shows that pulsatile patellar skin and bone blood flow, decreases significantly as a reaction to oxygen breathing in healthy subjects. The results suggest that a non-invasive PPG technique could be used to monitor blood flow changes in bone during oxygen treatment.

关键词： Photopletysmography Hyperbaric Oxygen Bone Osteomyelitis Blood Flow

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全外显子组测序表明层黏连蛋白亚基β3基因是重度肥胖的易感基因

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中华预防医学杂志 2017年第7期51卷 646-646页

作者： Jiao H Kulyte A naslund E 张美仙首都儿科研究所流行病学研究室

鉴定具有更大功能效应的罕见变异有助于阐明作用肥胖的新通路。该研究采用全外显子组测序结合基因分型技术，发现层黏连蛋白亚基β3（LAMB3）基因上的一个编码区低频变异rs2076349与重度肥胖具有强关联，

关键词：易感基因重度肥胖蛋白亚基外显子黏连测序 β3 基因分型技术

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